The Error of Estimated GFR in Type 2 Diabetes Mellitus

被引：16

作者：

Luis-Lima, Sergio ^{[1
]}

Higueras Linares, Tomas ^{[2
]}

Henriquez-Gomez, Laura ^{[3
]}

Alonso-Pescoso, Raquel ^{[3
]}

Jimenez, Angeles ^{[4
]}

Maria Lopez-Hijazo, Asuncion ^{[5
]}

Negrin-Mena, Natalia ^{[6
]}

Martin, Candelaria ^{[4
]}

Sanchez-Gallego, Macarena ^{[3
]}

Judith Galindo-Hernandez, Sara ^{[3
]}

Fernandez del Castillo, Raquel Socas ^{[7
]}

Castilla-Marrero, Manuel ^{[2
]}

Dominguez-Coello, Santiago ^{[8
]}

Vilchez de Leon, Vanesa ^{[7
]}

Valcarcel-Lopez, Rafael ^{[9
]}

Insausti-Garmendia, Nerea ^{[10
]}

Escamilla, Beatriz ^{[11
]}

Estupinan, Sara ^{[11
]}

Delgado-Mallen, Patricia ^{[11
]}

Armas-Padron, Ana-Maria ^{[10
]}

Marrero-Miranda, Domingo ^{[11
]}

Gonzalez-Rinne, Ana ^{[11
]}

Miquel Rodriguez, Rosa Maria ^{[11
]}

Angeles Cobo-Caso, Maria ^{[11
]}

Diaz-Martin, Laura ^{[6
]}

Gonzalez-Rinne, Federico ^{[6
]}

Gonzalez-Delgado, Alejandra ^{[12
]}

Lopez-Martinez, Marina ^{[13
]}

Jimenez-Sosa, Alejandro ^{[6
]}

Torres, Armando ^{[14
]}

Porrini, Esteban ^{[14
,15
]}

机构：

[1] IIS Fdn Jimenez Diaz, Dept Nephrol & Hypertens, Madrid 28040, Spain

[2] Ctr Salud Tejina, Tenerife 38260, Spain

[3] Hosp Univ Canarias, Endocrinol Dept, Tenerife 38320, Spain

[4] Ctr Salud Puerto Cruz Casco Bot, Tenerife 38400, Spain

[5] Ctr Salud Vera, Tenerife 38400, Spain

[6] Hosp Univ Canarias, Res Unit Dept, Tenerife 38320, Spain

[7] Ctr Salud Dehesas, Tenerife 38300, Spain

[8] Ctr Salud La Victoria de Acentejo, Tenerife 38380, Spain

[9] Ctr Salud Santa Ursula, Tenerife 38390, Spain

[10] Ctr Salud Cuesta, Tenerife 38320, Spain

[11] Hosp Univ Canarias, Nephrol Dept, Tenerife 38320, Spain

[12] Hosp Univ Canarias, Cent Lab, Tenerife 38320, Spain

[13] Hosp Badalona Germans Trias & Pujol, Nephrol Dept, Badalona 08916, Spain

[14] Univ La Laguna, ITB, Internal Med Dept, Tenerife 38320, Spain

[15] Univ Hosp Canary Isl, Unidad Ensayos Clin UCICEC, Ofra S-N La Cuesta, San Cristobal la Laguna 38320, Sc Tenerife, Spain

来源：

JOURNAL OF CLINICAL MEDICINE | 2019年 / 8卷 / 10期

关键词：

Type II diabetes mellitus; renal disease; estimated glomerular filtration rate; measured glomerular filtration rate; plasma clearance of iohexol; GLOMERULAR-FILTRATION-RATE; CHRONIC KIDNEY-DISEASE; RENAL-FUNCTION; CYSTATIN-C; SERUM CREATININE; EQUATIONS; PREVALENCE; PREDICTION; METABOLISM; FORMULA;

D O I：

10.3390/jcm8101543

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

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.

引用

页数：12

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