The Modification of Diet in Renal Disease (MDRD) equations provide valid estimations of glomerular filtration rates in patients with advanced heart failure

O’Meara, Eileen; Chong, Kwok S.; Gardner, Roy S.; Jardine, Alan G.; Neilly, J. B.; McDonagh, Theresa A.

doi:10.1016/j.ejheart.2005.04.013

Cited by 119 publications

(66 citation statements)

References 17 publications

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“…12 In the same study, the simplified MDRD formula had a mean bias of only 10.9 ml/min, compared with 51Cr-EDTA. In our data, the greatest mean bias between the methods was found between the CG and sMDRD formulas and was similar to the previous finding (9.06 ml/min).…”

mentioning

confidence: 89%

Assessing glomerular filtration rate in patients with severe heart failure: comparison between creatinine-based formulas

Libório

Uchoa²,

Neto

et al. 2012

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Severe heart failure is highly associated with chronic kidney disease (CKD). Serum creatinine is a poor indicator of renal function and glomerular filtration rate (GFR) estimation is an accessible method for assessing renal function. The most popular formulas for GFR estimation are the Cockcroft-Gault (CG), the four-variable Simplified Modification of Diet in Renal Disease (sMDRD) and the recently introduced CKD-Epidemiology Collaboration (CKD-EPI). The objective of the study was to analyze the correlation between these three equations for estimating GFR in patients with severe heart failure. DESIGN AND SETTING: Cross-sectional observational study at a university reference center. METHODS: GFR was estimated in patients with severe heart failure who were awaiting heart transplantation, using the CG, sMDRD and CKD-EPI formulas. These estimates were analyzed using Pearson's correlation and Bland-Altman analysis.RESULTS: This study included 157 patients, of whom 32 (20.3%) were female. Normal serum creatinine concentration was observed in 21.6%. The mean GFR according to CG, sMDRD and CKD-EPI was 70.1 ± 29.5, 70.7 ± 37.5 and 73.7 ± 30.1 ml/min/1.73 m 2 ; P ≥ 0.05. Pearson's coefficient demonstrated good correlations between all the formulas, as did Bland-Altman. However, the patients presented GFR < 60 ml/ min more frequently with the sMDRD formula (54.1% versus 40.2% for CG and 43.2% for CKD-EPI; P = 0.02). CONCLUSION: Despite the good correlation and agreement between the three methods, the sMDRD formula classified more patients as presenting GFR less than 60 ml/min. RESUMOCONTEXTO E OBJETIVO: Insuficiência cardíaca grave tem elevada correlação com doença renal crôni-ca. Creatinina sérica é um indicador pobre da função renal e a estimativa da taxa de filtração glomerular (TFG) é um método acessível para avaliar a função renal. As fórmulas mais populares estimadoras da TFG são a Cockcroft-Gault (CG), a modificação de dieta simplificada em doença renal (Simplified Modification of Diet in Renal Disease, sMDRD) com quatro variáveis, e a recentemente introduzida Colaboração Epidemiológica na Doença Renal Crônica (Chronic Kidney Disease-Epidemiology Collaboration, CKD--EPI). O objetivo foi analisar a correlação entre essas três equações estimadoras da TFG em pacientes com insuficiência cardíaca grave. ; P ≥ 0,05. Coeficiente de Pearson mostrou boa correlação entre todas as fór-mulas, assim como Bland-Altman. Entretanto, os pacientes apresentaram TFG < 60 ml/min mais frequentemente com a fórmula sMDRD (54,1% versus 40,2% para CG e 43,2% para CKD-EPI; P = 0,02). CONCLUSÃO: Apesar da boa correlação e concordância entre os três métodos, a fórmula do sMDRD classificou mais pacientes com TFG menor que 60 ml/min.

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confidence: 89%

Assessing glomerular filtration rate in patients with severe heart failure: comparison between creatinine-based formulas

Libório

Uchoa²,

Neto

et al. 2012

Sao Paulo Med. J.

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“…9 Transpulmonary gradient was calculated as the difference between mean PA and PCWP. Pulmonary vascular resistance (PVR) was calculated as transpulmonary gradient/ cardiac output.…”

Section: Variable Definitionsmentioning

confidence: 99%

Relationship of Right- to Left-Sided Ventricular Filling Pressures in Advanced Heart Failure

Drazner

Velez-Martinez

Ayers

et al. 2013

Circ: Heart Failure

106

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Background— Although right atrial pressure (RAP) and pulmonary capillary wedge pressure (PCWP) are correlated in heart failure, in a sizeable minority of patients, the RAP and PCWP are not tightly coupled. The basis of this variability in the RAP/PCWP ratio, and whether it conveys prognostic value, is not known. Methods and Results— We analyzed the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial database. Baseline characteristics, including echocardiographic assessment of right ventricular (RV) structure and function, and invasively measured hemodynamic parameters, were compared among tertiles of the RAP/PCWP ratio. Multivariable Cox proportional hazard models assessed the association of RAP/PCWP ratio with the primary ESCAPE outcome (6-month death or hospitalization [days]) adjusting for systolic blood pressure, blood urea nitrogen, 6-minute walk distance, and PCWP. The RAP/PCWP tertiles were 0.27 to 0.4 (tertile 1); 0.41 to 0.615 (tertile 2), and 0.62 to 1.21 (tertile 3). Increasing RAP/PCWP was associated with increasing median right atrial area (23, 26, 29 cm 2 , respectively; P <0.005), RV area in diastole (21, 27, 27 cm 2 , respectively; P <0.005), and pulmonary vascular resistance (2.4, 2.9, 3.6 woods units, respectively; P =0.003), and lower RV stroke work index (8.6, 8.4, 5.5 g·m/m 2 per beat, respectively; P <0.001). RAP/PCWP ratio was associated with death or hospitalization within 6 months (hazard ratio, 1.16 [1, 1.4]; P <0.05). Conclusions— Increased RAP/PCWP ratio was associated with higher pulmonary vascular resistance, reduced RV function (manifest as a larger right atrium and ventricle and lower RV stroke work index), and an increased risk of adverse outcomes in patients with advanced heart failure.

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“…The patients were excluded from the study for the following reasons: administration of inotropic therapy on the day of hospitalization (n=37); history of acute coronary syndrome or cardiogenic shock within the last month prior to the index hospitalization (n=6); prescription of potentially nephrotoxic drugs within the month before hospitalization (n=2); severe primary valvular disease (n=4); lack of at least 2 consecutive follow-up data regarding renal function before and after the infusions (n=7); being under renal replacement therapy before hospitalization (n=5); history of end-stage renal disease (n=12); and normal GFR ( glomerular filtration rate >90 ml/min/m 2 ) prior to administration of levosimendan (n=26). The GFR was estimated for each patient according to the Modification of Diet in Renal Disease (MDRD) formula 12 …”

Section: Methodsmentioning

confidence: 99%

Efeito do levosimendan em pacientes com insuficiência cardíaca sistólica severa e agravamento da função renal

Zorlu¹,

Yücel²,

Yontar³

et al. 2012

Arq. Bras. Cardiol.

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The Modification of Diet in Renal Disease (MDRD) equations provide valid estimations of glomerular filtration rates in patients with advanced heart failure

Cited by 119 publications

References 17 publications

Assessing glomerular filtration rate in patients with severe heart failure: comparison between creatinine-based formulas

Assessing glomerular filtration rate in patients with severe heart failure: comparison between creatinine-based formulas

Relationship of Right- to Left-Sided Ventricular Filling Pressures in Advanced Heart Failure

Efeito do levosimendan em pacientes com insuficiência cardíaca sistólica severa e agravamento da função renal

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