scholarly journals Jämförelse av CKD-EPI och MDRD ekvationsformler för estimerad glomerulär filtrationshastighet.

2020 ◽  
Vol 6 (1) ◽  
pp. 13-31
Author(s):  
Amanda Lundén ◽  
Ulrika Hafstad ◽  
Sara Larsson
Keyword(s):  
Glomerular Filtration Rate ◽  
Contrast Media ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Literature Study ◽  
Estimated Gfr ◽  
Contrast Induced Nephropathy ◽  
Mdrd Formula ◽  
The Moment

Introduction: In the profession as radiology nurse contrast media is used daily in radiologic examinations. In order to determine the volume of contrast media that patients should be administered and to prevent contrast-induced nephropathy equation formulas are applied to calculate the kidney function glomerular filtration rate. Two formulas were compared the CKD-EPI and MDRD. The aim was to compare which of the two most commonly used equation formulas is the most optimal for calculating estimated GFR. Methods: This study was conducted as a literature study, where 11 articles were quality assessed and compiled. Results: The CKD-EPI formula generally showed better performance for estimating GFR in accuracy, precision and bias than the MDRD formula. However, both equation formulas present inadequacies and are not universal as they are not applicable to all individuals. Conclusions: At the moment the CKD-EPI formula appears to be the most applicable, although more research is required in order to develop equation formulas which cater to all types of patients.

scholarly journals Racial Disparities in Creatinine-based Kidney Function Estimates Among HIV-infected Adults

2016 ◽  
Vol 26 (2) ◽  
pp. 213 ◽  
Author(s):  
Naomi Anker ◽  
Rebecca Scherzer ◽  
Carmen Peralta ◽  
Neil Powe ◽  
Tanushree Banjeree ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Racial Differences ◽  
Kidney Function ◽  
Filtration Rate ◽  
Department Of Veterans Affairs ◽  
Black And White ◽  
Risk Of Death ◽  
Mdrd Formula ◽  
The Impact

<p><strong>Objective</strong>: The aim of our study was to investigate whether current eGFR equations in clinical use might systematically overestimate the kidney function, and thus misclassify CKD status, of Black Americans with HIV. Specifically, we evaluated the impact of removing the race coefficient from the MDRD and CKD-EPI equations on comparisons between Black and White HIV-infected veterans related to: 1) the prevalence of reduced eGFR; 2) the distribution of eGFR values; and 3) the relationship between eGFR and all-cause mortality.</p><p><strong>Design:</strong> Retrospective cohort study.</p><p><strong>Setting:</strong> The Department of Veterans Affairs (VA) HIV Clinical Case Registry (CCR), which actively monitors all HIV-infected persons receiving care in the VA nationally.</p><p><strong>Patients/Participants:</strong> 21,905 treatmentnaïve HIV-infected veterans.</p><p><strong>Main Outcome Measures:</strong> Estimated glomerular filtration rate (eGFR) using the abbreviated Modification of Diet in Renal Disease (MDRD) formula with and without (MDRD-RCR) the race coefficient and allcause mortality.</p><p><strong>Results:</strong> Persons with eGFR &lt;45 mL/ min/1.73m2 had a higher risk of death compared with those with eGFR &gt;80 mL/ min/1.73m2 among both Blacks (HR=2.8, 95%CI: 2.4-3.3) and Whites (HR=1.9, 95%CI: 1.4-2.6), but the association appeared to be stronger in Blacks (P=.038, test for interaction). Blacks with eGFR 45- 60 mL/min/1.73m2 also had a higher risk of death (HR=1.7, 95%CI: 1.4-2.1) but Whites did not (HR=0.86, 95%CI: .67- 1.10; test for interaction: P&lt;.0001). Racial differences were substantially attenuated when eGFR was re-calculated without the race coefficient.</p><p><strong>Conclusions:</strong> Our findings suggest that clinicians may want to consider estimating glomerular filtration rate without the race coefficient in Blacks with HIV. <em>Ethn Dis.</em> 2016;26(2):213-220; doi:10.18865/ ed.26.2.213</p>

Cystatin C – an endogenous GFR marker and prognosis factor1)

2012 ◽  
Vol 36 (4) ◽  
Author(s):  
Rainer Woitas
Keyword(s):  
Glomerular Filtration Rate ◽  
Renal Insufficiency ◽  
Contrast Media ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Cystatin C ◽  
Filtration Rate ◽  
Clinical Symptoms ◽  
Sensitive Parameter ◽  
Everyday Routine

AbstractGlomerular filtration rate (GFR) is the most sensitive parameter of excretory kidney function. GFR reduction is usually detectable prior to the onset of clinical symptoms. Exact knowledge of GFR is helpful for pharmacotherapy and the use of contrast media. Everyday routine usually applies creatinine and creatinine-based equations to estimate GFR. However, because these equations were derived from patient cohorts with advanced renal insufficiency, they underestimate true GFR, if GFR is higher than 60 mL/min/1.73 m

scholarly journals MO415DOES LOW CONTRAST VOLUMES REDUCE RATES OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Emna Chaabouni ◽  
Hela Jbali ◽  
Najjar Mariem ◽  
Mzoughi Khadija ◽  
Zouaghi Mohamed karim
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Glomerular Filtration Rate ◽  
Coronary Angiography ◽  
Contrast Media ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Contrast Induced Nephropathy ◽  
Contrast Dose

Abstract Background and Aims Coronary angiography (CAG) necessitates administration of iodinated contrast, which may precipitate an acute deterioration in renal function (contrast-induced nephropathy). Previous work on contrast-induced nephropathy (CIN) has identified contrast volume as a risk factor and suggested that there is a toxic contrast dose above which the risk of CIN is markedly increased. The focus of this study is to provide a critical appraisal of this modifiable risk factor. Method We prospectively enrolled 158 patients who CAG with or without percutaneous coronary intervention from December 2017 to February 2018 at a cardiology department . CIN was defined as an increase in serum creatinine level &gt;25% or 0.5 mg/dL after 48 hours postcardiac catheterization. Toxic contrast dose was defined as a ratio volume of contrast media to estimated glomerular filtration rate (V/eGFR) &gt; 2 . Multivariable regression was conducted to evaluate the effect of exceeding the toxic contrast dose on CIN. Results Of 158 patients (females = 36.1%, mean age 60.0 ± 11 years) who underwent CAG , 15 (9,5%) developed CIN . The volume administered of contrast was not related to the existence of postprocedure CIN (96,6±35,9 ml vs 102,5±33,7ml , p=0,16). However , it was associated with a higher incidence of CIN in patients with chronic renal failure (90±19,1 ml vs 116,6±73,7ml , p=0,008) . The mean V/eGFR value was 1,2±0,7.Nine percent of patients exceeded the toxic contrast dose. After adjusting for other known predictors of CIN, a V/eGFR ratio &gt; 2 remained significantly associated with CIN (odds ratio 4.7, 95% confidence interval 1.28-17.7, P=0,02). Conclusion Low incidences of CIN suggest that a reduced dose of contrast agent is safe in high-risk patients with impaired renal function. A ratio volume of contrast media to estimated glomerular filtration rate &gt; 2 is a significant and independent predictor of CIN after CAG.

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 A Risk Score to Guide Cystatin C Testing to Detect Occult-Reduced Estimated Glomerular Filtration Rate

2015 ◽  
Vol 42 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Carmen A. Peralta ◽  
Paul Muntner ◽  
Rebecca Scherzer ◽  
Suzanne Judd ◽  
Mary Cushman ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Racial Differences ◽  
Kidney Function ◽  
Cystatin C ◽  
Risk Score ◽  
Filtration Rate ◽  
Bayesian Model Averaging ◽  
Estimated Glomerular Filtration Rate ◽  
Risk Function

Background/Aims: Persons with occult-reduced estimated glomerular filtration rate (eGFR <60 ml/min/1.73 m2 detected by serum cystatin C but missed by creatinine) have high risk for complications. Among persons with preserved kidney function by creatinine-based eGFR (eGFRcreat >60 ml/min/1.73 m2), tools to guide cystatin C testing are needed. Methods: We developed a risk score to estimate an individual's probability of reduced eGFR by cystatin C (eGFRcys <60 ml/min/1.73 m2) in The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and externally validated in the Third National Health and Nutrition Examination Survey (NHANES III). We used logistic regression with Bayesian model averaging and variables available in practice. We assessed performance characteristics using calibration and discrimination measures. Results: Among 24,877 adults with preserved kidney function by creatinine, 13.5% had reduced eGFRcys. Older and Black participants, current smokers and those with higher body mass index, lower eGFRcreat, diabetes, hypertension and history of cardiovascular disease were more likely to have occult-reduced eGFR (p < 0.001). The final risk function had a c-statistic of 0.87 in REGARDS and 0.84 in NHANES. By risk score, 72% of occult-reduced eGFR cases were detected by screening only 22% of participants. Conclusions: A risk score using characteristics readily accessible in clinical practice can identify the majority of persons with reduced eGFRcys, which is missed by creatinine.

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