Chronic kidney disease (CKD) and chronic kidney insufficiency (CKI) diagnosing equation in cirrhotic patients

Abstract

Cirrhotic patients can develop acute kidney injury (AKI), and chronic kidney disease (CKD).Therefore, renal functional evaluation is crucial in cirrhotic patients. However, serum creatinine and urea levels, as well as measured or estimated glomerular filtration rate is not reliable renal functional markers in these patients compared to other patient groups. In the present study, four original equations are designed and tested for screening chronic kidney disease (CKD) and chronic kidney insufficiency (CKI) in stable cirrhotic patients.Material & Method: estimated GFR (CKD-EPI creatinine and cystatin equations) were recorded in 175 adult stable patients suffering from cirrhosis, and these patients were classified as presenting or not CKD and CKI after evaluation by two independent nephrologists. Based on these data, the variables with the significant discriminating capability to identify CKD and CKI (based on creatinine and cystatin) were detected by applying the Student's t-test for two independent groups, later confirmed by the lambda test of Wilks, in order to obtain the renal function equations. Results:• CKD equation (creatinine) = 7.094238-0.043104 Â CKD-EPI creatinine -0.057537 Â haematocrit.• CKD equation (cystatin) = 8.375074-0.117218 Â CKD-EPI cystatin.• CKI equation (creatinine) = 0.428389-0.043214 Â CKD-EPI creatinine +0.183051 Â Child-Pugh score + 0.050162 Â age (in years).• CKI equation (cystatin) = 9.169579-0.139319 Â CKD-EPI cystatin. Conclusion:Simple and reliable equations have been obtained for screening chronic kidney disease and chronic kidney insufficiency in cirrhotic patients.