Performance of Serum Creatinine, Cockcroft-Gault and Modification of Diet in Renal Disease Study Equations in Assessment of Kidney Function in Patients with Arterial Hypertension

Abstract

SAŽEtAK: Cilj: utvrditi postoje li razlike između vrijednosti kreatinina u serumu, procijenjene stope glomerularne filtracije (eGFR) prema jednadžbi Modification of Diet in Renal Disease (MDRD), klirensa kreatinina i eGFR-a dobivenih Cockcroft-Gault metodom s obzirom na dob, stupanj i trajanje arterijske hipertenzije (AH).Bolesnici i metode: istraživanje je obuhvatilo 124 ambulantna bolesnika s AH-om pregledana na Klinici za bolesti srca, krvnih žila i reumatizam Kliničkog centra Univerziteta u Sarajevu. Pregledani su svi bolesnici te su uzeti podatci o trajanju i stupnju AH-a. Bubrežna je funkcija ocijenjena na osnovi serumskog kreatina, procijenjene su stope glomerularne filtracije prema MDRD jednadžbi, klirensom kreatinina procijenjenim Cockcroft-Gault jednadžbom (eCrCl CG ) i njegovim korekcijama za površinu tijela (eCrCl CG1,73 ), za indeks tjelesne mase (eCrCl CGBMI ), indeks tjelesne mase i površinu tijela (eCrCl CGBMI1,73 ) i procijenjeni GFR primjenom Cockcroft-Gault metode (eGFR CGBMI1,73 ).Rezultati: nađena je značajna razlika u vrijednostima procijenjenog GFR-a MDRD jednadžbom, eCrCl CGBMI , eCrCl CGBMI1,73 i eGFR CGBMI1,73 u bolesnika s različitim stupnjevima i trajanjem AH-a, što nije dobiveno analizom vrijednosti serumskog kreatinina.Zaključak: procijenjeni GFR i eCrCl osjetljiviji su biljezi oštećenja bubrega od vrijednosti kreatinina u serumu i njihovo određivanje treba biti uvedeno kao rutinski probir u otkrivanju ranih stadija kronične bubrežne bolesti u primarnoj zdravstvenoj zaštiti, posebno u bolesnika s AH-om.SUMMARY: Aim: To determine whether there are differences between serum creatinine levels, estimated glomerular filtration rate (GFR) according to the Modification of Diet in Renal Disease Study (MDRD) equation, creatinine clearance, and estimated GFR obtained by the Cockcroft-Gault method related to age, stage, and duration of arterial hypertension.Patients and Methods: The study included 124 patients with arterial hypertension who were examined at the Clinic for Heart, Rheumatism and Blood Vessels, Clinical Center University of Sarajevo. All patients were examined, and data about the duration and stage of hypertension were taken. Kidney function was assessed using serum creatinine, estimated GFR according to the MDRD equation, creatinine clearance estimated by the Cockcroft-Gault method (eCrCl CG ) and its corrections for body surface area (eCrCl CG1.73 ), body mass index (eCrCl CGBMI ), both body surface area and body mass index (eCrCl CGBMI1.73 ), and estimated GFR using the Cockcroft-Gault method (eGFR CGBMI1.73 ).Results: There was a significant difference in values in MDRD equation estimated GFR, eCrCl CGBMI , eCrCl CGBMI1.73 , and eGFR CGBMI1.73 in patients with different stages and durations of hypertension, which was not found by analysis of serum creatinine values. Conclusion: Estimated GFR and eCrCl are more sensitive markers of kidney impairment than serum creatinine values, and their assessment should be introduced as a routine screening in the detection of early stages of...