scholarly journals Development and Validation of Creatinine-Based Estimates of the Glomerular Filtration Rate Equation from 99mTc-DTPA Imaging in the Malaysian Setting

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Azrina Md Ralib ◽  
Farah Nadia Mohd Hanafiah ◽  
Iqbalmunawwir Abd Rashid ◽  
Mohamad Shahrir Abd Rahim ◽  
Fatimah Dzaharudin ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Gold Standard ◽  
Filtration Rate ◽  
Validation Cohort ◽  
The Other ◽  
Local Data ◽  
Cross Sectional ◽  
New Equation ◽  
Measured Gfr

Introduction. Accurate assessment of glomerular filtration rate (GFR) is very important for diagnostic and therapeutic intervention. Clinically, GFR is estimated from plasma creatinine using equations such as Cockcroft–Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations. However, these were developed in the Western population. To the best of our knowledge, there was no equation that has been developed specifically in our population. Objectives. We developed a new equation based on the gold standard of 99mTc-DTPA imaging measured GFR. We then performed an internal validation by comparing the bias, precision, and accuracy of the new equation and the other equations with the gold standard of 99mTc-DTPA imaging measured GFR. Methods. This was a cross-sectional study using the existing record of patients who were referred for 99mTc-DTPA imaging at the Nuclear Medicine Centre, International Islamic University Malaysia. As this is a retrospective study utilising routinely collected data from the existing pool of data, the ethical committee has waived the need for informed consent. Results. Data of 187 patients were analysed from January 2016 to March 2021. Of these, 94 were randomised to the development cohort and 93 to the validation cohort. A new equation of eGFR was determined as 16.637 ∗ 0.9935Age ∗ (SCr/23.473)−0.45159. In the validation cohort, both CKD-EPI and the new equation had the highest correlation to 99mTc-DTPA with a correlation coefficient of 0.81 ( p < 0.0001 ). However, the new equation had the least bias and was the most precise (mean bias of −3.58 ± 12.01) and accurate (P30 of 64.5% and P50 of 84.9%) compared to the other equations. Conclusion. The new equation which was developed specifically using our local data population was the most accurate and precise, with less bias compared to the other equations. Further study validating this equation in the perioperative and intensive care patients is needed.

scholarly journals Comparative Performance of Creatinine-Based Estimated Glomerular Filtration Rate Equations in the Malays: A Pilot Study in Tertiary Hospital in Malaysia

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Maisarah Jalalonmuhali ◽  
Ng Kok Peng ◽  
Lim Soo Kun
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Tertiary Hospital ◽  
Outpatient Setting ◽  
Rate Equations ◽  
Comparative Performance ◽  
Cross Sectional ◽  
Measured Gfr

Aim. To validate the accuracy of estimated glomerular filtration rate (eGFR) equations in Malay population attending our hospital in comparison with radiolabeled measured GFR.Methods. A cross-sectional study recruiting volunteered patients in the outpatient setting. Chromium EDTA (51Cr-EDTA) was used as measured GFR. The predictive capabilities of Cockcroft-Gault equation corrected for body surface area (CGBSA), four-variable Modification of Diet in Renal Disease (4-MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations were calculated.Results. A total of 51 subjects were recruited with mean measured GFR 42.04 (17.70–111.10) ml/min/1.73 m2. Estimated GFR based on CGBSA, 4-MDRD, and CKD-EPI were 40.47 (16.52–115.52), 35.90 (14.00–98.00), and 37.24 (14.00–121.00), respectively. Higher accuracy was noted in 4-MDRD equations throughout all GFR groups except for subgroup of GFR ≥ 60 ml/min/1.73 m2where CGBSA was better.Conclusions. The 4-MDRD equation seems to perform better in estimating GFR in Malay CKD patients generally and specifically in the subgroup of GFR < 60 ml/min/1.73 m2and both BMI subgroups.

STUDY OF RADIATION CHARACTERISTICS THE RENAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES

2014 ◽  
pp. 73-77
Author(s):  
Van Chuong Nguyen ◽  
Thi Kim Anh Nguyen
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Disease Duration ◽  
Left Kidney ◽  
Cross Sectional ◽  
The Right

Background: A Research glomerular filtration rate (GFR) of 61 patients with type 2 diabetes mellitus with renal scanning 99mTc-DTPA glomerular filtration rate at the hospital 175. Objective: (1) To study characteristics of imaging of renal function. (2) Understanding the relationship between GFR with blood sugar, HbA1c, blood pressure and albuminuria in patients with type 2 diabetes. Methods: Descriptive, prospective, cross-sectional study. Clinical examination, Clinical tests and 99mTc-DTPA GFR gamma - camera renography for patients. Result: GFR of the study group was 75,4 ± 22,3 ml/phut/1,73m2, the left kidney was 35,0 ± 13,0 is lower than the right kidney and 39,8 ± 11,9; p <0,01. There is no correlation between GFR with blood glucose and HbA1c, the risk of reduced GFR in hypertensive group associated is OR = 6,5 with p<0,01; albuminuria (+) is OR = 4,2 with p <0,01; and disease duration > 10 years is OR = 3,5 with p <0.01. Conclusion: GFR of the left kidneys is lower than the right kidney; correlation decreased GFR associated with hypertension, albuminuria and disease duration. Keywords: GFR, diabetes, albuminuria

scholarly journals Assessing glomerular filtration rate in healthy adult potential kidney donors in Bangladesh: A comparison of various prediction equations with measured glomerular filtration rate by diethylentriamine pentaacetic acid renogram

2014 ◽  
Vol 39 (2) ◽  
pp. 74-79
Author(s):  
F Jahan ◽  
MNU Chowdhury ◽  
T Mahbub ◽  
SM Arafat ◽  
S Jahan ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Healthy Adult ◽  
Healthy Population ◽  
Prediction Equations ◽  
Estimated Gfr ◽  
Kidney Donors ◽  
Measured Gfr

To ensure that potential kidney donors in Bangladesh have no renal impairment, it is extremely important to have accurate methods for evaluating the glomerular filtration rate (GFR). We evaluated the performance of serum creatinine based GFR in healthy adult potential kidney donors in Bangladesh to compare GFR determined by DTPA with that determined by various prediction equations. In this study GFR in 61 healthy adult potential kidney donors were measured with 99mTc-diethylenetriamine penta-acetic acid (DTPA) renogram. We also estimated GFR using a four variable equation modification of diet in renal disease (MDRD), Cockcroft-Gault creatinine clearance (CG CrCl), Cockcroft-Gault glomerular filtration rate (CG-GFR). The mean age of study population was 34.31±9.46 years and out of them 65.6% was male. In this study mean mGFR was 85.4±14.8. Correlation of estimated GFR calculated by CG-CrCl, CG-GFR and MDRD were done with measured GFR DTPA using quartile. Kappa values were also estimated which was found to be 0.104 for (p=0.151), 0.336 for (p=0.001) and 0.125 for (p=0.091) respectively. This indicates there is no association between estimated GFR calculated by CG-CrCl, CG-GFR, MDRD with measured GFR DTPA. These results show poor performance of these equations in evaluation of renal function among healthy population and also raise question regarding validity of these equations for assessment of renal function in chronic kidney disease in our population. DOI: http://dx.doi.org/10.3329/bmrcb.v39i2.19646 Bangladesh Med Res Counc Bull 2013; 39: 74-79

scholarly journals Performance of Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate Equations Depends on Patient Characteristics

2015 ◽  
Vol 61 (10) ◽  
pp. 1265-1272 ◽  
Author(s):  
Jeffrey W Meeusen ◽  
Andrew D Rule ◽  
Nikolay Voskoboev ◽  
Nikola A Baumann ◽  
John C Lieske
Keyword(s):  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Patient Characteristics ◽  
Transplant Recipients ◽  
Ckd Stage ◽  
Measured Gfr

Abstract BACKGROUND The Kidney Disease Improving Global Outcomes (KDIGO) guideline recommends use of a cystatin C–based estimated glomerular filtration rate (eGFR) to confirm creatinine-based eGFR between 45 and 59 mL · min−1 · (1.73 m2)−1. Prior studies have demonstrated that comorbidities such as solid-organ transplant strongly influence the relationship between measured GFR, creatinine, and cystatin C. Our objective was to evaluate the performance of cystatin C–based eGFR equations compared with creatinine-based eGFR and measured GFR across different clinical presentations. METHODS We compared the performance of the CKD-EPI 2009 creatinine-based estimated GFR equation (eGFRCr) and the newer CKD-EPI 2012 cystatin C–based equations (eGFRCys and eGFRCr-Cys) with measured GFR (iothalamate renal clearance) across defined patient populations. Patients (n = 1652) were categorized as transplant recipients (n = 568 kidney; n = 319 other organ), known chronic kidney disease (CKD) patients (n = 618), or potential kidney donors (n = 147). RESULTS eGFRCr-Cys showed the most consistent performance across different clinical populations. Among potential kidney donors without CKD [stage 2 or higher; eGFR &gt;60 mL · min−1 · (1.73 m2)−1], eGFRCys and eGFRCr-Cys demonstrated significantly less bias than eGFRCr; however, all 3 equations substantially underestimated GFR when eGFR was &lt;60 mL · min−1 · (1.73 m2)−1. Among transplant recipients with CKD stage 3B or greater [eGFR &lt;45 mL · min−1 · (1.73 m2)−1], eGFRCys was significantly more biased than eGFRCr. No clear differences in eGFR bias between equations were observed among known CKD patients regardless of eGFR range or in any patient group with a GFR between 45 and 59 mL · min−1 · (1.73 m2)−1. CONCLUSIONS The performance of eGFR equations depends on patient characteristics that are readily apparent on presentation. Among the 3 CKD-EPI equations, eGFRCr-Cys performed most consistently across the studied patient populations.

scholarly journals Albuminuria and glomerular filtration rate in obese children and adolescents

2019 ◽  
Vol 41 (2) ◽  
pp. 193-199
Author(s):  
Luciana Satiko Sawamura ◽  
Gabrielle Gomes de Souza ◽  
Juliana Dias Gonçalves dos Santos ◽  
Fabíola Isabel Suano-Souza ◽  
Anelise Del Vecchio Gessullo ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Children And Adolescents ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Cross Sectional Study ◽  
Systemic Arterial Pressure ◽  
Model Assessment ◽  
Obese Children ◽  
Cross Sectional ◽  
The Mean

Abstract Objective: To describe the frequency of albuminuria in overweight and obese children and adolescents and to relate it to the severity of obesity, pubertal staging, associated morbidities and the glomerular filtration rate. Method: Cross-sectional study including 64 overweight and obese children and adolescents between 5 and 19 years of age. Data collected: weight, height, waist circumference and systemic arterial pressure. Laboratory tests: lipid profile; glycemia and insulin, used to calculate the Homeostasis Model Assessment (HOMA-IR); C-reactive protein; glutamic-pyruvic transaminase and albuminuria in an isolated urine sample (cutoff <30 mg/g). Creatinine was used to calculate the estimated glomerular filtration rate (eGFR, mL/min/1.73 m2). Results: The mean age was 11.6 ± 3.4 years, 32 (50%) and 29 (45.3%) were male and prepubertal. Forty-six (71.9%) had severe obesity. The frequency and median (min/max) of the observed values for albuminuria (> 30 mg/g) were 14 (21.9%) and 9.4 mg/g (0.70, -300.7 mg/g). The mean eGFR was 122.9 ± 24.7 mL/min/1.73 m2. There was no significant correlation between body mass index, pubertal staging, insulin and HOMA-IR with albuminuria values and neither with eGFR. Children with albuminuria tended to have higher values of diastolic blood pressure (75.0 ± 12.2 vs. 68.1 ± 12.4, p = 0.071). Conclusion: Albuminuria, although frequent in children and adolescents with obesity, was not associated with other morbidities and the glomerular filtration rate in these patients.

scholarly journals Profile of estimated glomerular filtration rate of children with Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome

2019 ◽  
Vol 6 (5) ◽  
pp. 1931
Author(s):  
Gabriel O. Ezeh ◽  
Oluseyi Oniyangi ◽  
Iretiola B. Babaniyi ◽  
Vincent E. Nwatah ◽  
Felicia U. Eke
Keyword(s):  
Glomerular Filtration Rate ◽  
Hiv Infection ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Developed Countries ◽  
People Living With Hiv ◽  
Schwartz Formula ◽  
Cross Sectional ◽  
Female Ratio ◽  
The Mean

Background: Kidney disease is more common in people of African descent in developed countries. Studies reporting estimate Glomerular Filtration Rate (eGFR) in African populations and people living with HIV have been carried more frequently on adults than children. The study aimed to assess eGFR by use of the SCHWARTZ formula in HIV infected children seen at tertiary hospital.Methods: A descriptive, prospective and cross sectional study of 221 children with HIV infection. Schwartz formula was used to determine eGFR. The main outcome measures were eGFR. The study population comprised HIV infected children attending Paediatric out-patients’ clinic and those admitted into the Paediatric wards, aged between 6 months and 15 years. Data was analysed using SPSS version 20 and results presented in tables and figures. Results: The age range of the study subjects was 12 months to 15 years with the mean age and SD of 8.21±3.61 years. There were 129 (58.4%) male and 92 (41.6%) female children with male to female ratio 1: 0.7.  The mean age for males was 7.87±3.49 years while that for females was 8.70±3.71 years. The eGFR for the study as determined by Schwartz formula had a range of 49.21 to 463.67 ml/ min/ 1.73m2 with the mean of 159.56±59.04 ml/min. The mean eGFR for the males and females were 166.39±63.54ml/ min and 149.99±45.01 ml/ min respectively. Conclusion: The study, in comparison with other studies, observed a lower prevalence of CKD in HIV infected children. Detection of CKD in HIV infection children may be more optimal if combined methods are employed.

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