A simple method for correcting overestimated glomerular filtration rate in obese subjects evaluated by the Cockcroft and Gault formula: a comparison with 51Cr EDTA clearance

Saracino, A.; Morrone, L F; Suriano, V.; Asabella, Artor Niccoli; Ramunni, Alfonso; Fanelli, Margherita; Rubini, Giorgia; Coratelli, P

doi:10.5414/cnp62097

Cited by 23 publications

(15 citation statements)

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“…There is also evidence that, for obese individuals, the Cockcroft-Gault formula overestimates the actual value of CrCl. 18 Another limiting factor is that studies on large samples have shown only a moderate correlation between CrCl estimated through formulae and that measured directly with different laboratory methods. That fact has been confirmed in our study, in which a correlation coefficient of only 0.48 was observed between CrCl measured in the 24-hour urine collection and that calculated by use of the CockcroftGault formula.…”

Section: Resultsmentioning

confidence: 99%

Correlação entre a depuração plasmática de creatinina utilizando urina coletada durante 24 horas e 12 horas

Silva¹,

Molina²,

Rodrigues³

et al. 2010

J. Bras. Nefrol.

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Introduction: Creatinine concentration in plasma has been used to evaluate renal function. However, the endogenous creatinine clearance (CrCl) is more sensitive to this goal. Objective: Correlate the CrCl calculated from urinary collects of 12 h and 24 h. Methods: Ninety five volunteers (34-64 y) collected the urine for 24 h into two bottles: night, from 7 am to 7 pm and day, from 6 am to 7 pm. A fasting blood sample was used to measure plasma creatinine. Correlation between variables was determined by Pearson method (r) and the agreement between night and 24 h CrCl was determined by the Bland-Altman plot. Results: Urines of 4 individuals were discarded because of collect errors. In the final sample (n = 91; 42 males), hypertension was found in 23 and diabetic in 5. The CrCl (mL/min/1.73 m 2 ) was slightly lower in females in the night (77.8 ± 22.7 versus 88.4 ± 23.6; p < 0.05) and similar in males (91.2 ± 22.9 versus 97.3 ± 30.9; p > 0.05). Strong correlations were observed between the CrCl calculated from the night and day urines and the 24 h (r = 0.85 and 0.83; respectively). Agreement between the CrCl calculated from night or day urine and the 24 h urine was observed, respectively, to 85 and 83 individuals. Conclusion: The 12 h urine, mainly obtained at night, gives CrCl values similar to those obtained in the 24 h collect. Since urine collect is easier to outpatients at night, this period should be chosen in the clinical evaluation of the glomerular filtration rate.

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Section: Resultsmentioning

confidence: 99%

Correlação entre a depuração plasmática de creatinina utilizando urina coletada durante 24 horas e 12 horas

Silva¹,

Molina²,

Rodrigues³

et al. 2010

J. Bras. Nefrol.

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“…The value of GFR was estimated using creatinine clearance as measured by 24-h urine sample, without correcting for body surface area, because the correction would underestimate considerably the real value of the GFR (29). For the same reason, we did not use other types of formulas to estimate the GFR (Cockcroft- Gault and Modification of Diet in Renal Disease), because these formulas are designed for patients with chronic renal failure and, if applied to our study population, also would underestimate the real value of GFR (30,31). Almost half of the EO patients in our study presented with albuminuria and/or proteinuria before undergoing BS.…”

Section: Discussionmentioning

confidence: 99%

Effect of Drastic Weight Loss after Bariatric Surgery on Renal Parameters in Extremely Obese Patients

Navarro-Díaz

Serra

Romero

et al. 2006

Journal of the American Society of Nephrology

219

156

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Obesity is a health problem that is reaching epidemic proportions. Extreme obesity (body mass index [BMI] >40 kg/m2 ) is a type of obesity that usually does not respond to medical treatment, with surgery being the current treatment of choice. Extreme obesity is associated with cardiovascular disease, type 2 diabetes, dyslipidemia, and hypertension. Recently, obesity has been related with high rate of renal lesions, but renal function and renal parameters in extreme obesity scarcely are documented. The objective of this study was to evaluate the effect of weight loss after bariatric surgery (BS) on BP, renal parameters, and renal function in 61 extremely obese (EO) patients after 24 mo of follow-up. A total of 61 EO adults (37 women) were studied prospectively before and 24 mo after surgery. Control subjects were 24 healthy, normal-weight adults (15 women). Anthropometric, BP, and renal parameters were determined. Presurgery weight, BMI, GFR, 24-h proteinuria, and 24-h albuminuria were higher in the EO patients than in control subjects (P < 0.001). All parameters improved at 12 mo after BS. However, during the second year of follow-up, only 24-h albuminuria (P ‫؍‬ 0.006) and BMI (P ‫؍‬ 0.014) continued to improve. At 24 mo after BS, obesity-related renal alterations considerably improved. This improvement was observed mainly in the first year after surgery, when the majority of weight loss occurred. However, 24-h albuminuria still improves during the second year of follow-up. It is possible that this decrease in 24-h albuminuria is not GFR related but rather is attributable to the persistence of the decrease in BMI and to the improvement of other weight-related metabolic factors.

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“…The discrepant results regarding GFR in obese versus normal-weight individuals might mainly be explainable by the use of creatinine clearance for the estimation of GFR, as this might be an imprecise instrument that has not been validated for obese patients: in general, GFR is underestimated when ideal body weight (IBW) is used and overestimated when total body weight (TBW) is used. The estimation of GFR using the weightindependent MDRD (Modification of Diet in Renal Disease) formula has been shown to correlate better with 51 Cr-EDTA clearance than the estimation using the CockroftGault formula (r = 0.818 vs. r = 0.687) [10], however, the result of the MDRD formula is given in ml/min/1.73 m 2 with the limitation of incorrect body surface area (BSA) estimation in obese individuals. A recent report found no significant differences in GFR measured by [ 125 I]Na isothalamate clearance in morbidly obese patients as compared to normal weight controls (116.0 vs. 93.5 ml/min, P = 0.36) [11].…”

Section: Resultsmentioning

confidence: 99%

Drug dosing and monitoring in obese patients undergoing allogenic stem cell transplantation

et al. 2011

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A simple method for correcting overestimated glomerular filtration rate in obese subjects evaluated by the Cockcroft and Gault formula: a comparison with 51Cr EDTA clearance

Cited by 23 publications

References 0 publications

Correlação entre a depuração plasmática de creatinina utilizando urina coletada durante 24 horas e 12 horas

Correlação entre a depuração plasmática de creatinina utilizando urina coletada durante 24 horas e 12 horas

Effect of Drastic Weight Loss after Bariatric Surgery on Renal Parameters in Extremely Obese Patients

Drug dosing and monitoring in obese patients undergoing allogenic stem cell transplantation

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