Fluid intake and chronic kidney disease: effect of coaching an increase in fluid intake on kidney function decline

Bozzano, Viviana; Abati, Elena; Metodologica, Gruppo di Autoformazione

doi:10.1007/s11739-018-1952-5

Cited by 1 publication

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“…CKD is a frequent condition among hospitalized patients due to its close association with increasing age and various co-morbidities. This relation is particularly strong in patients with cardiovascular diseases (CVD), including acute and chronic coronary syndrome (ACS and CCS), heart failure (HF), or atrial fibrillation (AF) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Several studies emphasized the bidirectional relation between renal function and cardiovascular outcomes [5,[20][21][22] as CVD is responsible for 40-50% of all deaths in nephropathic patients [5,23,24], and CKD, even in early stages, has been related to fatal and nonfatal cardiovascular events, regardless of traditional cardiovascular risk factors [25][26][27][28][29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome

Malavasi

Valenti

Ruggerini

et al. 2022

JCM

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Background: This paper aims to evaluate the concordance between the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and alternative equations and to assess their predictive power for all-cause mortality in unselected patients discharged alive from a cardiology ward. Methods: We retrospectively included patients admitted to our Cardiology Division independently of their diagnosis. The total population was classified according to Kidney Disease: Improving Global Outcomes (KDIGO) categories, as follows: G1 (estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m2); G2 (eGFR 89–60 mL/min/1.73 m2); G3a (eGFR 59–45 mL/min/1.73 m2); G3b (eGFR 44–30 mL/min/1.73 m2); G4 (eGFR 29–15 mL/min/1.73 m2); G5 (eGFR <15 mL/min/1.73 m2). Cockcroft-Gault (CG), CG adjusted for body surface area (CG-BSA), Modification of Diet in Renal Disease (MDRD), Berlin Initiative Study (BIS-1), and Full Age Spectrum (FAS) equations were also assessed. Results: A total of 806 patients were included. Good agreement was found between the CKD-EPI formula and CG-BSA, MDRD, BIS-1, and FAS equations. In subjects younger than 65 years or aged ≥85 years, CKD-EPI and MDRD showed the highest agreement (Cohen’s kappa (K) 0.881 and 0.588, respectively) while CG showed the lowest. After a median follow-up of 407 days, overall mortality was 8.2%. The risk of death was higher in lower eGFR classes (G3b HR4.35; 95%CI 1.05–17.80; G4 HR7.13; 95%CI 1.63–31.23; G5 HR25.91; 95%CI 6.63–101.21). The discriminant capability of death prediction tested with ROC curves showed the best results for BIS-1 and FAS equations. Conclusion: In our cohort, the concordance between CKD-EPI and other equations decreased with age, with the MDRD formula showing the best agreement in both younger and older patients. Overall, mortality rates increased with the renal function decreasing. In patients aged ≥75 years, the best discriminant capability for death prediction was found for BIS-1 and FAS equations.

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