Évaluation de la fonction rénale au-delà de 80 ans : formule de Cockroft et Gault ou Modification of diet in renal disease ?

Andro, Marion; Estivin, S.; Comps, Emmanuelle; Gentric, A.

doi:10.1016/j.revmed.2010.12.010

Cited by 10 publications

(1 citation statement)

References 27 publications

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“…Despite the high correlation ( r p = 90%) between these two methods in our study, the CG-estimated GFR identified more individuals as having low eGFR (<60 mL/min per 1.73 m 2 ) than the MDRD-estimated eGFR (16.3% versus 8.5%). Our finding corroborates with previous observations in other populations [29, 30]. For example, Wetmore et al found that 5.3% of the subjects in their study were classified by the MDRD equation as having CKD (eGFR < 60 mL/min per 1.73 m 2 ) whereas 19.7% were classified by the CG formula [29].…”

Section: Discussionsupporting

confidence: 92%

Circulating Adiponectin Is Associated with Renal Function Independent of Age and Serum Lipids in West Africans

Doumatey

Zhou

Huang

et al. 2012

International Journal of Nephrology

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Adiponectin, a protein secreted by adipose tissue, has been associated with renal dysfunction. However, these observations have not been adequately investigated in large epidemiological studies of healthy individuals in general and in African populations in particular. Hence, we designed this study to evaluate the relationship between adiponectin and renal function in a large group of nondiabetic West Africans. Total adiponectin was measured in 792 participants. MDRD and Cockroft-Gault (CG-) estimated GFR were used as indices of renal function. Linear and logistic regression models were used to determine the relationship between adiponectin and renal function. Adiponectin showed an inverse relationship with eGFR in univariate (BetaMDRD = −0.18, BetaCG = −0.26) and multivariate (BetaMDRD = −0.10, BetaCG = −0.09) regression analyses. The multivariate models that included age, sex, BMI, hypertension, smoking, HDL-C, LDL-C, triglycerides, and adiponectin explained 30% and 55.6% of the variance in GFR estimated by MDRD and CG methods, respectively. Adiponectin was also a strong predictor of moderate chronic kidney disease (defined as eGFR < 60 mL/min/1.73 m2). We demonstrate that adiponectin is associated with renal function in nondiabetic West Africans. The observed relationship is independent of age and serum lipids. Our findings suggest that adiponectin may have clinical utility as a biomarker of renal function.

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Section: Discussionsupporting

confidence: 92%

Circulating Adiponectin Is Associated with Renal Function Independent of Age and Serum Lipids in West Africans

Doumatey

Zhou

Huang

et al. 2012

International Journal of Nephrology

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Glomerular Filtration Rate Equations Overestimate Creatinine Clearance in Older Individuals Enrolled in the Baltimore Longitudinal Study on Aging: Impact on Renal Drug Dosing

et al. 2013

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Objectives To evaluate performance of kidney function estimation equations and to determine the frequency of drug dose discordance in an older population. Design Cross-sectional analysis of data from community-dwelling volunteers randomly selected from the Baltimore Longitudinal Study of Aging from January 1, 2005–December 31, 2010. Subjects Two hundred sixty-nine men and women with a mean ± SD age of 81 ± 6 years, mean serum creatinine concentration (Scr) of 1.1 ± 0.4 mg/dl, and mean measured 24-hour creatinine clearance (mClcr) of 53 ± 13 ml/minute. Measurements and Main Results Kidney function was estimated by using the following equations: Cockcroft-Gault (CG), Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). The performance of each equation was assessed by measuring bias and precision relative to mClcr. Dose calculation errors (discordance) were determined for 10 drugs requiring renal dosage adjustments to avoid toxicity when compared to the FDA-approved dosages. The CG equation was the least biased estimate of mClcr. The MDRD and CKD-EPI equations were significantly positively biased compared to CG (mean ± SD 34 ± 20% and 22 ± 15%, respectively, p<0.001) and mClcr (29 ± 47% and 18 ± 40%, respectively, p<0.001). Rounding low Scr values (< 1.0 mg/dl) up to an arbitrary value of 1.0 mg/dL resulted in CG values (44±10 mL/min) that were significantly lower than mClcr (56±12 mL/min, p<0.001) and CG (56±15 mL/min, p<0.001). The MDRD and CKD-EPI equations had median dose discordance rates of 28.6% and 22.9%, respectively. Conclusion The MDRD and CKD-EPI equations significantly overestimated creatinine clearance (mClcr and CG) in elderly individuals. This leads to dose calculation errors for many drugs, particularly in individuals with severe renal impairment. Thus, GFR-estimating equations should not be substituted in place of the CG equation in older adults for the purpose of renal dosage adjustments. In addition, the common practice of rounding or replacing low Scr values with an arbitrary value of 1.0 mg/dL for use in the CG equation should be avoided. Additional studies that evaluate alternative eGFR equations in the older populations that incorporate pharmacokinetic and pharmacodynamic outcomes measures are needed.

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Clairet¹,

Gérard²,

Jouanny³

et al. 2018

Pharmacie Clinique Et Thérapeutique

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Évaluation de la fonction rénale au-delà de 80 ans : formule de Cockroft et Gault ou Modification of diet in renal disease ?

Cited by 10 publications

References 27 publications

Circulating Adiponectin Is Associated with Renal Function Independent of Age and Serum Lipids in West Africans

Circulating Adiponectin Is Associated with Renal Function Independent of Age and Serum Lipids in West Africans

Glomerular Filtration Rate Equations Overestimate Creatinine Clearance in Older Individuals Enrolled in the Baltimore Longitudinal Study on Aging: Impact on Renal Drug Dosing

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