BACKGROUND: detecting chronic kidney disease (CKD) may have important implications for the management of older and frail people. We aimed at investigating whether clinical setting (nursing home: NH versus hospital: H) affects the agreement between glomerular filtration rate (GFR) values estimated by Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI), Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations. DESIGN: observational study. SETTING: comparison between NH residents and H patients. SUBJECTS: we used data from 177 NH residents, and 439 H patients. METHODS: the agreement between estimating equations and the odds of a discrepancy >25% between formulas in relation to setting (NH versus H) were investigated. RESULTS: the agreement between MDRD and CKD-EPI formulas was good either in NH (k = 0.82) or H (k = 0.87) patients, while corresponding figures for CG indicate only a fair agreement with CKD-EPI (k = 0.50 for both populations). Setting (NH versus H) was associated with discordance between MDRD and CKD-EPI (OR = 3.97; 95% CI = 1.75-9.01), but not between CG and EPI (OR = 1.25; 95% CI = 0.87-1.81). CONCLUSIONS: in NH residents, MDRD and CKD-EPI formulas yield highly concordant GFR values, but CG behaves differently in up to one-third of patients. Such findings have important implications in dosing drugs cleared by the kidney. Setting should be taken into consideration in studies for validation of GFR equations.
BACKGROUND: detecting chronic kidney disease (CKD) may have important implications for the management of older and frail people. We aimed at investigating whether clinical setting (nursing home: NH versus hospital: H) affects the agreement between glomerular filtration rate (GFR) values estimated by Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI), Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations. DESIGN: observational study. SETTING: comparison between NH residents and H patients. SUBJECTS: we used data from 177 NH residents, and 439 H patients. METHODS: the agreement between estimating equations and the odds of a discrepancy >25% between formulas in relation to setting (NH versus H) were investigated. RESULTS: the agreement between MDRD and CKD-EPI formulas was good either in NH (k = 0.82) or H (k = 0.87) patients, while corresponding figures for CG indicate only a fair agreement with CKD-EPI (k = 0.50 for both populations). Setting (NH versus H) was associated with discordance between MDRD and CKD-EPI (OR = 3.97; 95% CI = 1.75-9.01), but not between CG and EPI (OR = 1.25; 95% CI = 0.87-1.81). CONCLUSIONS: in NH residents, MDRD and CKD-EPI formulas yield highly concordant GFR values, but CG behaves differently in up to one-third of patients. Such findings have important implications in dosing drugs cleared by the kidney. Setting should be taken into consideration in studies for validation of GFR equations.
Authors: A Clara Drenth-van Maanen; Paul A F Jansen; Johannes H Proost; Toine C G Egberts; Arjan D van Zuilen; Dawi van der Stap; Rob J van Marum Journal: Br J Clin Pharmacol Date: 2013-10 Impact factor: 4.335
Authors: A Mocroft; L Ryom; P Reiss; H Furrer; A D'Arminio Monforte; J Gatell; S de Wit; M Beniowski; J D Lundgren; O Kirk Journal: HIV Med Date: 2013-10-03 Impact factor: 3.180
Authors: Sabrina Garasto; Sergio Fusco; Francesco Corica; Maria Rosignuolo; Antonio Marino; Alberto Montesanto; Francesco De Rango; Marcello Maggio; Vincenzo Mari; Andrea Corsonello; Fabrizia Lattanzio Journal: Biomed Res Int Date: 2014-03-20 Impact factor: 3.411