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Revista médica de Chile

versão impressa ISSN 0034-9887

Resumo

VEGA, Jorge; HUIDOBRO E., Juan Pablo  e  SEPULVEDA, Rodrigo Andrés. Comparison of different methods to estimate glomerular filtration rate in older adults. Rev. méd. Chile [online]. 2021, vol.149, n.2, pp.187-195. ISSN 0034-9887.  http://dx.doi.org/10.4067/s0034-98872021000200187.

Background:

Glomerular filtration rate (GFR) estimation in older adults using a creatinine clearance/24-hour (CrCl) or an equation based on serum creatinine, are often considered equivalent by clinicians.

Aim:

To compare GFR estimated (eGFR) with the available equations and measured CrCl in patients ≥ 70 years. A secondary aim was to know the differences in chronic kidney disease (CKD) classification, when using the different eGFR formulas.

Patients and Methods:

In 144 patients aged 77 ± 5 years (58% men), CrCl was measured and GFR was estimated using MDRD, CKD-EPI, BIS-1 and FAS formulas. The eGFR and the stage of CKD were compared according to the different equations used.

Results:

GFR estimated by MDRD and CKD-EPI equations was 7.8 and 8.4 mL/min/1.73 m2 lower than 24-hour ClCr, respectively. This difference was even greater using the BIS-1 and FAS equations. Twenty-four-hour CrCl classified 47.2% of the patients in a category of renal function > 60 mL/min/1.73 m2, while MDRD and CKD-EPI equations classified just over a third, and BIS-1 and FAS formulas around 20% of the patients.

Conclusions:

The practice of considering equivalent the GFR estimation using the creatinine-based equations with measured creatinine clearance in older adults should be reconsidered, because their results differ markedly.

Palavras-chave : Creatinine; Glomerular Filtration Rate; Kidney Function Tests; Renal Insufficiency, Chronic.

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