Comparación del uso de las ecuaciones de estimación del filtrado glomerular renal en personas de 75 años o más sin enfermedad renal conocida

Gómez-Pavón, Javier; Gálvez‐Barrón, César; Cortés, Juan José Baztán; Cantera, Isidoro Ruipérez

doi:10.1016/j.medcli.2009.09.037

Cited by 7 publications

(9 citation statements)

References 13 publications

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“…Highest correlation with 24 h-CrCl was obtained by CG ( R = 0.70, P < 0.001). These data are in agreement with the data by Gómez-Pavón et al [ 22 ] who reported a better correlation between CG and 24 h-CrCl than between other formulas and 24 h-CrCl.…”

Section: Discussionsupporting

confidence: 93%

Renal Function and Ultrasound Imaging in Elderly Subjects

Zanoli

Romano

et al. 2014

The Scientific World Journal

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We evaluated in elderly subjects (a) the ability of GFR formulas to discriminate chronic kidney disease (CKD), (b) the correlation between renal morphology and function, and (c) the usefulness of combined r-US and GFR formulas to detect CKD. A total of 72 patients were enrolled (mean age 80 ± 7 years, male sex 44%, serum creatinine 0.98 ± 0.42 mg/dL, and CKD 57%). Cockcroft-Gault showed the highest sensitivity (78%) and specificity (94%) for CKD and was correlated with kidney volume (R = 0.68, P < 0.001). All formulas failed to provide a reliable estimate of GFR. In multivariate analysis, Cockcroft-Gault < 52 mL/min and kidney sinus section area < 28 cm2 showed the highest accuracy for the identification of CKD subjects (AUC 0.90, P < 0.001). MDRD and CKD-EPI differed significantly for GFR ≥90 mL/min. Conclusions. Cockcroft-Gault < 52 mL/min was able to discriminate subjects with CKD but all formulas failed to provide a reliable estimate of GFR. The combined use of r-US and Cockcroft-Gault formula improved the ability to discriminate CKD in elderly subjects.

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Section: Discussionsupporting

confidence: 93%

Renal Function and Ultrasound Imaging in Elderly Subjects

Zanoli

Romano

et al. 2014

The Scientific World Journal

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“…Se encontró que la fórmula MDRD sobrestimaba la VFG entre 13 y 19 ml/min/1,73 m 2 , produciendo un error en la clasificación de los pacientes en las etapas de ERC y en la proporción de pacientes con diagnóstico de IRC. La ecuación de C.G, en cambio, dio resultados muy similares al ClCr/24 -h. Concluyeron que la fórmula MDRD no era apropiada para este tipo de pacientes 15,21,29,30 .…”

Section: Rol Del Clearance De Creatinina En La Estimación De La Vfg En El Adulto Mayorunclassified

“…El ClCr/24h en AM, especialmente en los pacientes ambulatorios, tiene dificultades en su ejecución (incontinencia urinaria, daño cognitivo, limitación funcional), contrario a lo que ocurre a la de sujetos más jóvenes, resultando muchas veces impracticable 15,21 .…”

Section: Rol Del Clearance De Creatinina En La Estimación De La Vfg En El Adulto Mayorunclassified

“…= 175 × creatinina −1,154 × age −0,203 × 1,212 (si afroamericano) × 0,742 (si es mujer) En 9 publicaciones que comunicaron los resultados de comparaciones entre las fórmulas de C.G y MDRD o CKD-EPI o ambas, efectuadas en 10.018 pacientes de 78 años en promedio, provenientes de distintos países, demostraron invariablemente que la fórmula de C.G subestimaba tanto el ClCr/24h medido, como las mediciones de VFG con métodos de referencia y las estimaciones de eVFG con MDRD y CKD-EPI 4,9,15,20,21,29,33,[36][37][38] (Tablas 2 y 3). Por ello se ha encontrado discutible seguir usando en la práctica clínica la fórmula de C.G en AM, estimándose que ella está obsoleta 4,9 .…”

Section: Mdrd-4 Idms (Estandarizada)unclassified

“…: antibióticos), mientras que una sobrestimación puede asociarse a la administración de dosis tóxicas 20 . Esto ocurre frecuentemente en los AM, habiéndose comunicado que hasta 10% de los ingresos hospitalarios en mayores de 65 años se deben a reacciones adversas a medicamentos 21 .…”

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Evaluación de la función renal en adultos mayores

Vega

2021

Rev. méd. Chile

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The evaluation of renal function in older adults is usually carried out with a creatinine clearance or an estimation of glomerular filtration rate using formulas such as Cockcroft-Gault, MDRD or CKD-EPI. The results obtained with these formulas are often regarded as equivalent. However, in adults older than 70 years, the Cockcroft-Gault formula frequently underestimates the glomerular filtration rate with respect to reference methods and the MDRD formula overestimates it. CKD-EPI has a more unpredictable behavior. This leads to erroneously classifying patients in the stages of chronic kidney disease (CKD), artificially increasing the prevalence of this condition, overloading health systems and generating emotional disorders in patients mistakenly classified as carriers of CKD. Also, when kidney function is overestimated, CKD patients are prevented from receiving the treatments appropriate for their condition. In recent years, new formulas have been proposed (FAS, BIS) with a greater accuracy to estimate glomerular filtration rate in older adults. This review describes the behavior of these formulas in a significant number of older adults, from various countries, and proposes using those equations with the best performance in older adults.

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