- A Validation Study on eGFR Equations in Chinese Patients With Diabetic or Non-diabetic CKD. [Journal Article]Front Endocrinol (Lausanne) 2019; 10:581FE
- CONCLUSIONS: This study showed that eGFR equations were less accurate in the diabetic group than in the non-diabetic group. CKD-EPIScr-CysC had the best performance among CKD-EPI equations in Chinese diabetic CKD patients. The other five equations did not significantly improve the performance of GFR estimates. BMI, mGFR, DKD status, and HbA1c were independent factors associated with accuracy in eGFR equations.
- Estimated glomerular filtration rate using a point of care measure of creatinine in patients with iohexol determinate GFR. [Journal Article]Clin Chim Acta 2019; 499:123-127CC
- CONCLUSIONS: Creatinine measured with the POC has an acceptable performance when used with the CKD-EPI equation to estimate GFR. Its ability to detect GFR <60 mL/min/1.73m2 is not significantly different from the classical Roche assay. StatSensor Creatinine (Nova Biomedical) can be used for GFR screening before contrast media injection.
- Diagnostic performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation at estimating glomerular filtration rate in adults with diabetes mellitus: a systematic review and meta-analysis protocol. [Journal Article]BMJ Open 2019; 9(8):e031558BO
- Timely detection leading to the implementation of reno-protective measures reduces the progression of diabetic kidney disease. Estimated glomerular filtration rate (eGFR) is a major surrogate of kidney function. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Equation is a tool to estimate GFR. This protocol outlines a systematic-review, assessing the diagnostic accuracy of the CK…
Timely detection leading to the implementation of reno-protective measures reduces the progression of diabetic kidney disease. Estimated glomerular filtration rate (eGFR) is a major surrogate of kidney function. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Equation is a tool to estimate GFR. This protocol outlines a systematic-review, assessing the diagnostic accuracy of the CKD-EPI equation in adults with diabetes.
- A cross-sectional cohort study with microvascular complications in patients with type 2 diabetes with and without hypothyroidism. [Journal Article]Cardiovasc J Afr 2019; 30:1-4CJ
- CONCLUSIONS: Hypothyroidism in T2DM was not associated with microvascular disease after adjusting for confounding factors. There was a nearly two-fold risk of CVD. The study is limited by the retrospective and observational design.
- Prevalence of positive chronic kidney Disease screening in professional male long haul drivers at risk of cardiovascular Disease in Lagos, Nigeria: a cross-section study. [Journal Article]BMC Public Health 2019; 19(1):1032BP
- CONCLUSIONS: Professional male long distance drivers in addition to having very high prevalence of clustering of both CVD and CKD risk factors have a significant burden of asymptomatic CKD. UACR appears to be an earlier marker of CKD in this population. Health awareness promotion and aggressive risk factor reduction are advocated as ways to reduce this burden.
- Association of diabetic foot ulcers with chronic vascular diabetic complications in patients with type 2 diabetes. [Journal Article]Diabetes Metab Syndr 2019 Mar - Apr; 13(2):1287-1292DM
- CONCLUSIONS: Chronic vascular diabetic complications are common among type 2 diabetic patients with diabetic foot ulcers. There is statistically significant association between these complications and diabetic peripheral neuropathy (DPN) and peripheral arterial disease (PAD).
- StatPearls: Creatinine Clearance [BOOK]StatPearls Publishing: Treasure Island (FL)BOOK
- The measurement of accurate renal function is vital for the routine care of patients. Determining the renal function status can predict kidney disease progression and prevent toxic drug levels in the body. The glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidneys. The gold standard measurement of GFR involves the injection of inulin and its clearance…
The measurement of accurate renal function is vital for the routine care of patients. Determining the renal function status can predict kidney disease progression and prevent toxic drug levels in the body. The glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidneys. The gold standard measurement of GFR involves the injection of inulin and its clearance by the kidneys. However, the use of inulin is invasive, time-consuming, and an expensive procedure. Alternatively, the biochemical marker creatinine found in serum and urine is commonly used in the estimation of GFR. Creatinine clearance (CrCl) is the volume of blood plasma cleared of creatinine per unit time. It is a rapid and cost-effective method for the measurement of renal function. Both CrCl and GFR can be measured using the comparative values of creatinine in blood and urine. Glomerular Filtration Rate The GFR in the measurement of volume filtered through the glomerular capillaries and into the Bowman’s capsule per unit of time. The filtration in the kidney is dependent on the difference in high and low blood pressure created by the afferent (input) and efferent (output) arterioles, respectively. The clearance rate for a given substance equals the GFR when it is neither secreted nor reabsorbed by the kidneys. For such given substance, the urine concentration multiplied by the urine flow equals the mass of substance excreted during the time of urine collection. This mass divided by the plasma concentration is equivalent to the volume of plasma from which the mass was originally filtered. Below is the equation used to determine GFR, typically recorded in volume per time (e.g., mL/min): GFR = [UrineX (mL/mg)] * urine flow (mL/min)/ [PlasmaX (mL/mg)], where X is a substance that is completely excreted. GFR approximation using Creatinine Clearance Creatinine is a breakdown product of dietary meat and creatine phosphate found in skeletal muscle. Its production in the body is dependent on muscle mass. The CrCl rate approximates the calculation of GFR since the glomerulus freely filters creatinine. However, it is also secreted by the peritubular capillaries, causing CrCl to overestimate the GFR by approximately 10% to 20%. Despite the marginal error, it is an accepted method for measuring GFR due to the ease of measurement of CrCl. Cockcroft-Gault formula: Estimated creatinine clearance rate (eCCR) Creatinine clearance can be estimated using serum creatinine levels. The Cockcroft-Gault (C-G) formula uses a patient’s weight (kg) and gender to predict CrCl (mg/dL). The resulting CrCl is multiplied by 0.85 if the patient is female to correct for the lower CrCl in females. The C-G formula is dependent on age as its main predictor for CrCl. Below is the formula: eCCr = (140 – Age) x Mass (kg) x [0.85 if female] / 72 x [Serum Creatinine (mg/dL)] Formulas used in the prediction of GFR Formulas derived using variables that influence GFR can provide varying degrees of accuracy in estimating GFR. The widely used Modification of Diet in Renal Disease Study Group (MDRD) employs four variables, including serum creatinine, age, ethnicity, and albumin levels. A further complex version of MDRD includes blood urea nitrogen and serum albumin in its formula. However, since MDRD formula does not adjust for body size, results of eGFR are given in units of ml^-1 min^-1 1.73m^-2, 1.73m^2 due to body surface area in an adult with a mass of 63kg and height of 1.7m. Other formulas used for GFR calculations and their employed variables to estimate GFR include Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas. The CKD-EPI formulas are in categories based on patients that are a black female, black male, non-black female, and non-black male. The Mayo Quadratic formula was developed to better estimate GFR in patients that have preserved renal function. Estimation of GFR in children uses the Schwartz formula, which employs serum creatinine (mg/dL) and child’s height (cm). In current clinical practice, the use of creatinine derived the KDIGO clinical practice guidelines recommend CKD-EPI formula for the estimation of GFR.
- Pretransplant renal function evaluated by serum cystatin C was associated with mortality after liver transplantation: a single-center experience. [Journal Article]Ann Transl Med 2019; 7(11):243AT
- CONCLUSIONS: The pretransplant renal function evaluated by serum CystC was associated with mortality after LT and could be used for predicting post-transplant survival.
- Revised Equations to Estimate Glomerular Filtration Rate from Serum Creatinine and Cystatin C in China. [Journal Article]Kidney Blood Press Res 2019; 44(4):553-564KB
- CONCLUSIONS: C-CKD-EPIcys was the most accurate with the highest P30 value, relative lowest IQR, and RMSE among 6 equations. C-CKD-EPIscr and C-CKD-EPIscr-cys equations were improved in bias, precision, and accuracy. Other external validation of these equations is needed.
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- Impaired renal function in a rural Ugandan population cohort. [Journal Article]Wellcome Open Res 2018; 3:149WO
- CONCLUSIONS: In a systematic survey of people in rural Uganda, we found a substantial proportion had eGFR<60 ml/min/1.73 m 2, and this was strongly associated with high blood pressure and anaemia.