Introduction: Serum creatinine is not enough sensitive marker for the evaluation of glomerular filtration rate (GFR). Cockcroft-Gault (CG) formula is often used to assess GFR, but it is necessary to correct original one for body surface area (BSA), adipositas, and the creatinine tubular secretion. The values of the estimated creatinine clearance and GFR are considered to Poggio reference ones according to biological parameters (age and gender). The aim of the study was to determine the difference in renal function estimation between serum creatinine and corrected CG equation according to the Poggio reference values in the arterial hypertension patients. Materials and Methods: The research included 124 patients of both gender with arterial hypertension, excluding ones with the already verified chronic kidney disease. We estimated creatinine clearance and GFR by CG method corrected for the BSA, body mass index (BMI), and the creatinine tubular secretion according to Poggio reference values. Results: There was no significant difference in both age and gender groups among patients with physiological and pathological values of the renal function determined by the serum creatinine and estimated creatinine clearance by CG equation corrected for BMI, BSA. In both age and gender groups there was significant difference among subjects with physiological and pathological values of the renal function determined by serum creatinine and estimated GFR by CG method corrected for BMI, BSA, and creatinine tubular secretion. Conclusion: There is the most striking difference in the assessment of renal function between serum creatinine and estimated GFR by CG method with three corrections (BSA, BMI, the creatinine tubular secretion). Estimated GFR by CG method with three corrections can help in the early diagnosis of renal dysfunction and optimal treatment in patients with arterial hypertension.

SAŽEtAK: Cilj: utvrditi postoje li razlike između vrijednosti kreatinina u serumu, procijenjene stope glomerularne filtracije (eGFR) prema jednadžbi Modification of Diet in Renal Disease (MDRD), klirensa kreatinina i eGFR-a dobivenih Cockcroft-Gault metodom s obzirom na dob, stupanj i trajanje arterijske hipertenzije (AH).Bolesnici i metode: istraživanje je obuhvatilo 124 ambulantna bolesnika s AH-om pregledana na Klinici za bolesti srca, krvnih žila i reumatizam Kliničkog centra Univerziteta u Sarajevu. Pregledani su svi bolesnici te su uzeti podatci o trajanju i stupnju AH-a. Bubrežna je funkcija ocijenjena na osnovi serumskog kreatina, procijenjene su stope glomerularne filtracije prema MDRD jednadžbi, klirensom kreatinina procijenjenim Cockcroft-Gault jednadžbom (eCrCl CG ) i njegovim korekcijama za površinu tijela (eCrCl CG1,73 ), za indeks tjelesne mase (eCrCl CGBMI ), indeks tjelesne mase i površinu tijela (eCrCl CGBMI1,73 ) i procijenjeni GFR primjenom Cockcroft-Gault metode (eGFR CGBMI1,73 ).Rezultati: nađena je značajna razlika u vrijednostima procijenjenog GFR-a MDRD jednadžbom, eCrCl CGBMI , eCrCl CGBMI1,73 i eGFR CGBMI1,73 u bolesnika s različitim stupnjevima i trajanjem AH-a, što nije dobiveno analizom vrijednosti serumskog kreatinina.Zaključak: procijenjeni GFR i eCrCl osjetljiviji su biljezi oštećenja bubrega od vrijednosti kreatinina u serumu i njihovo određivanje treba biti uvedeno kao rutinski probir u otkrivanju ranih stadija kronične bubrežne bolesti u primarnoj zdravstvenoj zaštiti, posebno u bolesnika s AH-om.SUMMARY: Aim: To determine whether there are differences between serum creatinine levels, estimated glomerular filtration rate (GFR) according to the Modification of Diet in Renal Disease Study (MDRD) equation, creatinine clearance, and estimated GFR obtained by the Cockcroft-Gault method related to age, stage, and duration of arterial hypertension.Patients and Methods: The study included 124 patients with arterial hypertension who were examined at the Clinic for Heart, Rheumatism and Blood Vessels, Clinical Center University of Sarajevo. All patients were examined, and data about the duration and stage of hypertension were taken. Kidney function was assessed using serum creatinine, estimated GFR according to the MDRD equation, creatinine clearance estimated by the Cockcroft-Gault method (eCrCl CG ) and its corrections for body surface area (eCrCl CG1.73 ), body mass index (eCrCl CGBMI ), both body surface area and body mass index (eCrCl CGBMI1.73 ), and estimated GFR using the Cockcroft-Gault method (eGFR CGBMI1.73 ).Results: There was a significant difference in values in MDRD equation estimated GFR, eCrCl CGBMI , eCrCl CGBMI1.73 , and eGFR CGBMI1.73 in patients with different stages and durations of hypertension, which was not found by analysis of serum creatinine values. Conclusion: Estimated GFR and eCrCl are more sensitive markers of kidney impairment than serum creatinine values, and their assessment should be introduced as a routine screening in the detection of early stages of...

No abstract