Palabras clave
tasa de filtración glomerular
creatinina
diabetes mellitus
enfermedad renal crónica
Cómo citar
Resumen
Contexto: los métodos utilizados actualmente para calcular el filtrado glomerular subestiman esta medición en la población de pacientes diabéticos; por ende, existe la necesidad de desarrollar métodos específicos para la diabetes que estimen el filtrado glomerular en esta población.
Objetivo: este estudio tiene como objetivo evaluar un modelo predictivo basado en el uso de la HbA1c para estimar la variabilidad del filtrado glomerular en pacientes diabéticos con o sin enfermedad renal crónica.
Métodos: analizamos datos de pacientes diabéticos pertenecientes a una cohorte de seguimiento prospectivo de un programa de vigilancia de salud renal adscrito a un hospital peruano. Los siguientes factores se incluyeron en el modelo de regresión lineal múltiple: edad, sexo, presión arterial diastólica (PAD), presión arterial sistólica (PAS), índice de masa corporal (IMC), colesterol, triglicéridos, HDL, LDL, creatinina sérica, creatinina urinaria, microalbuminuria, hemoglobina, glucemia basal y HbA1c.
Resultados: se incluyeron 122 pacientes en el análisis. El modelo multivariado final, que incluía la variación de la HbA1c, la edad y la variación de la creatinina, fue altamente significativo (p < 0,0001), con un R2 ajustado del 80 %. Las otras variables analizadas no fueron significativas para predecir la variación del filtrado glomerular, a pesar de mostrar cierta correlación.
Conclusiones: el estudio demuestra que la HbA1c, la edad y la variación de la creatinina predicen significativamente la variación del filtrado glomerular en pacientes diabéticos con o sin enfermedad renal crónica, y abre la posibilidad de su uso como herramienta de pronóstico para esta población específica.
Citas
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