The Error of Estimated GFR in Type 2 Diabetes Mellitus
Por:
Luis-Lima, S, Linares, TH, Henriquez-Gomez, L, Alonso-Pescoso, R, Jimenez, A, Lopez-Hijazo, AM, Negrin-Mena, N, Martin, C, Sanchez-Gallego, M, Galindo-Hernandez, SJ, del Castillo, RSF, Castilla-Marrero, M, Dominguez-Coello, S, de Leon, VV, Valcarcel-Lopez, R, Insausti-Garmendia, N, Escamilla, B, Estupinan, S, Delgado-Mallen, P, Armas-Padron, AM, Marrero-Miranda, D, Gonzalez-Rinne, A, Rodriguez, RMM, Cobo-Caso, MA, Diaz-Martin, L, Gonzalez-Rinne, F, Gonzalez-Delgado, A, Lopez-Martinez, M, Jimenez-Sosa, A, Torres, A and Porrini, E
Publicada:
1 oct 2019
Ahead of Print:
26 sep 2019
Resumen:
Type 2 diabetes mellitus represents 30-50% of the cases of end stage renal disease worldwide. Thus, a correct evaluation of renal function in patients with diabetes is crucial to prevent or ameliorate diabetes-associated kidney disease. The reliability of formulas to estimate renal function is still unclear, in particular, those new equations based on cystatin-C or the combination of creatinine and cystatin-C. We aimed to assess the error of the available formulas to estimate glomerular filtration rate in diabetic patients. We evaluated the error of creatinine and/or cystatin-C based formulas in reflecting real renal function over a wide range of glomerular filtration rate (from advanced chronic kidney disease to hyperfiltration). The error of estimated glomerular filtration rate by any equation was common and wide averaging 30% of real renal function, and larger in patients with measured glomerular filtration rate below 60 mL/min. This led to chronic kidney disease stages misclassification in about 30% of the individuals and failed to detect 25% of the cases with hyperfiltration. Cystatin-C based formulas did not outperform creatinine based equations, and the reliability of more modern algorithms proved to be as poor as older equations. Formulas failed in reflecting renal function in type 2 diabetes mellitus. Caution is needed with the use of these formulas in patients with diabetes, a population at high risk for kidney disease. Whenever possible, the use of a gold standard method to measure renal function is recommended.
Filiaciones:
Luis-Lima, S:
IIS Fdn Jimenez Diaz, Dept Nephrol & Hypertens, Madrid 28040, Spain
Linares, TH:
Ctr Salud Tejina, Tenerife 38260, Spain
Henriquez-Gomez, L:
Hosp Univ Canarias, Endocrinol Dept, Tenerife 38320, Spain
Alonso-Pescoso, R:
Hosp Univ Canarias, Endocrinol Dept, Tenerife 38320, Spain
Jimenez, A:
Ctr Salud Puerto Cruz Casco Bot, Tenerife 38400, Spain
Lopez-Hijazo, AM:
Ctr Salud Vera, Tenerife 38400, Spain
Negrin-Mena, N:
Hosp Univ Canarias, Res Unit Dept, Tenerife 38320, Spain
Martin, C:
Ctr Salud Puerto Cruz Casco Bot, Tenerife 38400, Spain
Sanchez-Gallego, M:
Hosp Univ Canarias, Endocrinol Dept, Tenerife 38320, Spain
Galindo-Hernandez, SJ:
Hosp Univ Canarias, Endocrinol Dept, Tenerife 38320, Spain
del Castillo, RSF:
Ctr Salud Dehesas, Tenerife 38300, Spain
Castilla-Marrero, M:
Ctr Salud Tejina, Tenerife 38260, Spain
Dominguez-Coello, S:
Ctr Salud La Victoria de Acentejo, Tenerife 38380, Spain
de Leon, VV:
Ctr Salud Dehesas, Tenerife 38300, Spain
Valcarcel-Lopez, R:
Ctr Salud Santa Ursula, Tenerife 38390, Spain
Insausti-Garmendia, N:
Ctr Salud Cuesta, Tenerife 38320, Spain
Escamilla, B:
Hosp Univ Canarias, Nephrol Dept, Tenerife 38320, Spain
Estupinan, S:
Hosp Univ Canarias, Nephrol Dept, Tenerife 38320, Spain
Delgado-Mallen, P:
Hosp Univ Canarias, Nephrol Dept, Tenerife 38320, Spain
Armas-Padron, AM:
Ctr Salud Cuesta, Tenerife 38320, Spain
Marrero-Miranda, D:
Hosp Univ Canarias, Nephrol Dept, Tenerife 38320, Spain
Gonzalez-Rinne, A:
Hosp Univ Canarias, Nephrol Dept, Tenerife 38320, Spain
Rodriguez, RMM:
Hosp Univ Canarias, Nephrol Dept, Tenerife 38320, Spain
Cobo-Caso, MA:
Hosp Univ Canarias, Nephrol Dept, Tenerife 38320, Spain
Diaz-Martin, L:
Hosp Univ Canarias, Res Unit Dept, Tenerife 38320, Spain
Gonzalez-Rinne, F:
Hosp Univ Canarias, Res Unit Dept, Tenerife 38320, Spain
Gonzalez-Delgado, A:
Hosp Univ Canarias, Cent Lab, Tenerife 38320, Spain
:
Hosp Badalona Germans Trias & Pujol, Nephrol Dept, Badalona 08916, Spain
Jimenez-Sosa, A:
Hosp Univ Canarias, Res Unit Dept, Tenerife 38320, Spain
Torres, A:
Univ La Laguna, ITB, Internal Med Dept, Tenerife 38320, Spain
Porrini, E:
Univ La Laguna, ITB, Internal Med Dept, Tenerife 38320, Spain
Univ Hosp Canary Isl, Unidad Ensayos Clin UCICEC, Ofra S-N La Cuesta, San Cristobal la Laguna 38320, Sc Tenerife, Spain
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