Creatinine clearance: a comparative study of five equations to estimate glomerular filtration rate in outpatients in a public health service
DOI:
https://doi.org/10.33448/rsd-v10i9.17875Keywords:
Clinical laboratory diagnostics; Glomerular filtration rate; Renal elimination.Abstract
The correct diagnosis of chronic kidney disease (CKD) depends on several equations to estimate the glomerular filtration rate (GFR), such as Cockroft-Gault (CG), MDRD and CKD-EPI. The objective was to estimate and compare the GFR obtained by different equations, using data from patients seen in a public clinical analysis laboratory (LRR). A retrospective, cross-sectional, descriptive study was carried out, using data from 7828 patients and estimating the GFR values using the CG equations with real weight (CG1) and ideal weight (CG2), MDRD and CKD-EPI for comparison with the LRR results (cLRR group), using ANOVA and both Student t-test and Bonferroni post-test, and compared with international criteria for CKD. The GFR values are statistically different. The CG1 group is similar to cLRR. All equations (except CG2) appear to produce convergent results for GFR ≥ 60 mL/min. When GFR ≤ 29.0 mL/min, the cLRR frequency is the same as that of CG1; however, compared with the data obtained by the other equations, the patients’ number is considerably higher, which suggests a refinement in the way of classifying CKD. As for the intermediate GFR values (30-59 mL/min), indicative of mild-moderate and moderate-severe GFR reduction, the CG2 data fits 31.5% of the patients, against 8-10.4% of the other equations. Thus, the estimate of GFR varies according to the chosen equation, especially for GFR <60 mL/min and the CKD-EPI equation produces better statistically distributed values, highlighting the need to estimate GFR using several equations simultaneously.
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Copyright (c) 2021 Marianna Medeiros Barros da Cunha; Leonardo Antonucci Moretti; Letícia de Souza Cainelli; Pedro Rodrigo Medeiros Barros da Cunha; Alessandro de Carvalho Cruz; Carla Danielle Dias Costa; Flávia Neri Meira; Renzo Freire de Almeida; Luiz Carlos da Cunha
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