Relation between Cockcroft-Gault, MDRD-4 and CKD-EPIformulas, compared with the 24-hour creatinin depuration
PDF (Español (España))
XML (Español (España))

Keywords

Glomerular filtration rate
creatinine
geriatric health services
renal insufficiency
chronic
nephrology

How to Cite

1.
Navarro Guarnizo EF, Ceron Tapia HR, Zamora Suarez A. Relation between Cockcroft-Gault, MDRD-4 and CKD-EPIformulas, compared with the 24-hour creatinin depuration: Correlación entre las fórmulas de medición de filtrado glomerular Cockcroft- Gault, MDRD-4 y CKD-EPI, y la depuración de creatinina de 24 horas. Rev. Colomb. Nefrol. [Internet]. 2020 Nov. 5 [cited 2022 May 18];8(1):e458. Available from: https://revistanefrologia.org/index.php/rcn/article/view/458

Abstract

Introduction:
It is currently evident that the population pyramid has undergone significant changes in recent times. The increase in the number of older adults brings with it new challenges at the medical level, such as the adaptation and adaptation of formulas and parameters that allow efficient and effective medical care to be provided. Among them, the determination of the glomerular filtration rate becomes a parameter of vital importance given its relationship with increased cardiovascular risk and general morbidity in this group of patients.

Objective:
To compare, in patients over 85 years without known chronic kidney disease, different formulas for calculating the glomerular filtration rate with diagnostic standard 24-hour creatinine clearance, in order to establish the best correlation between MDRD, CKD-EPI and Cockcroft-Gault.

Materials and methods:
A prospective, descriptive, cross-sectional observational study including 25 patients admitted to the Geriatrics service of the Juarez Hospital in Mexico, in the period from June 2017 to June 2018, serum creatinine levels were measured upon arrival, with 24-hour urine collection and performed filtering rate calculations with the CKDEPI, MDRD and Cockcroft Gault formulas.

Results:
The average glomerular filtration rate measured by creatinine clearance in 24 hours was 48.35 ml/min/1.73 m2; according to the formula of Cockcroft and Gault was 41.49 ml/min/1.73m2, significantly lower than with MDRD and CKD-EPI 64.98 ml/min/1.73 m2-57.0/ml/min/1.73 m2 respectively. There is a direct correlation between the different types of formulas; however, the one with the greatest statistical power and reciprocity is Cockcroft and Gault being statistically significant.

Conclusions:
In elderly patients, the formulas for the measurement of glomerular filtration rate are not interchangeable, showing an advantage for Cockcroft and Gault, being statistically significant (P < 0.05), however, it is necessary to perform more extensive studies in geriatric population, to have a more accurate estimate.

https://doi.org/10.22265/acnef.8.1.458
PDF (Español (España))
XML (Español (España))

References

Varela-Pinedo LF. Salud y calidad de vida en el adulto mayor. Rev Peru Med Exp SaludPublica. 2016;33(2):199-201. http://dx.doi.org/10.17843/rpmesp.2016.332.2196

Ebert N, Jakob O, Gaedeke J, van der Giet M, Kuhlmann M, Martus P,et al.Prevalence ofreduced kidney function and albuminuria in older adults: the Berlin Initiative Study. Neph-rol Dial Transplant. 2017;32(6):997-1005. https://dx.doi.org/10.1093/ndt/gfw079

Losito A, Zampi I, Pittavini L, Zampi E. Association of reduced kidney function with car-diovascular disease and mortality in elderly patients; comparison between the new Ber-lin initiative study ( BIS1) and the MDRD study equations. J Nephrol. 2015;30(1):81-6.https://dx.doi.org/10.1007/s40620-015-0244-7

Álvarez Gregori J, Musso CG, Robles Pérez-Monteolivac NR, Pérez del Villard JH. ¿Es váli-do el valor crítico de ltrado glomerular estimado de 60 ml/min para etiquetar de insucien-cia renal a personas mayores de 70 años? Consecuencias de su aplicación indiscriminada.2011;4(3):1-58. https://dx.doi.org/10.3265/NefroPlus.pre2011.Nov.11231

Warnock DG. Estimated glomerular Filtration Rate: Fit for what purpose? Nephron.2016;134(1):43-9. https://dx.doi.org/10.1159/000444062

Garasto S, Fusco S, Corica F, Rosignuolo M, Marino A, Montesanto A,et al.EstimatingGlomerular Filtration Rate in Older People. Biomed Res Int. 2014;2014:916542. https://dx.doi.org/10.1155/2014/916542

Lattanzio F, Corsonello A, Abbatecola AM, Volpato S, Pedone C, Pranno L,et al.Rela-tionship between renal Funtion and physical performance in elderly hospitalized patients.Rejuvenation Res. 2012;15(6):545-52. https://dx.doi.org/10.1089/rej.2012.1329

Gonzalez-Otero A. Envejecimiento y funcion renal. Mecanismos de predic-ción y progresión. Nefrologia Sup Ext. 2011;2(5);119-30. https://dx.doi.org/10.3265/NefrologiaSuplementoExtraordinario.pre2011.Jul.11085

Willems JM, Vlasveld T, den Elzen WP, Westendorp RG, Rabelink TJ, de Craen AJ,et al.Performance of Cockcroft-Gault, MDRD, and CKD-EPI in estimating prevalence of renalfunction and predicting survival in the oldest old. BMC Geriatr. 2013;13:113. https://dx.doi.org/10.1186/1471-2318-13-113

Raman M, Middleton RJ, Kalra PA, Green D. Estimating renal function in old people:a depth review. Maharajan Raman, Int Urol Nephrol. 2017;49(1):1979-88. https://dx.doi.org/10.1007/s11255-017-1682-z

Gomez-Carracedo A, Baztan-Cortes JJ. Metodos de evaluacion de la funcion renal en elpaciente anciano: abilidad e implicaciones cl?nicas. Revista Española de Geriatría y Ge-rontología. 2009;44(5):266-72. https://dx.doi.org/10.1016/j.regg.2009.03.016

Karsch-Völk M, Schmid E, Wagenpfeil S, Linde K, Heemann U, Schneider A. Kidney fun-ction and clinical recommendations of drug dose adjustment in geriatric patients. BMCGeriatr. 2013;13:92. https://dx.doi.org/10.1186/1471-2318-13-92

Drenth-van Maanen AC, Jansen PA, Proost JH, Egberts TC, van Zuilen AD, van der StapD,et al.Renal function assessment in older adults. Br J Clinl Pharmacol. 2013;76(4):616-23.https://dx.doi.org/10.1111/bcp.12199

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2020 Revista Colombiana de Nefrología

Downloads

Download data is not yet available.