The Prognostic Impact of Estimated Creatinine Clearance by Bioelectrical Impedance Analysis in Heart Failure: Comparison of Different eGFR Formulas

Abstract

The estimation of glomerular filtration rate (eGFR) provides prognostic information in patients with heart failure (HF). Bioelectrical impedance analysis may calculate eGFR (Donadio formula). The aim of this study was to evaluate the impact of the Donadio formula in predicting all-cause mortality in patients with HF as compared to Cockroft-Gault, MDRD-4 (Modification of Diet in renal Disease Study), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas. Four-hundred thirty-six subjects with HF (52% men; mean age 75 ± 11 years; 42% acute HF) were enrolled. Ninety-two patients (21%) died during the follow-up (median 463 days, IQR 287–669). The area under the receiver operator characteristic curve for eGFR, as estimated by Cockroft-Gault formula (AUC = 0.75), was significantly higher than those derived from Donadio (AUC = 0.72), MDRD-4 (AUC = 0.68), and CKD-EPI (AUC = 0.71) formulas. At multivariate analysis, all eGFR formulas were independent predictors of death; 1 mL/min/1.73 m2 increase in eGFR—as measured by Cockroft-Gault, Donadio, MDRD-4, and CKD-EPI formulas—provided a 2.6%, 1.5%, 1.2%, and 1.6% increase, respectively, in mortality rate. Conclusions. eGFR, as calculated with the Donadio formula, was an independent predictor of mortality in patients with HF as well as the measurements derived from MDRD4 and CKD-EPI formulas, but less accurate than Cockroft-Gault.

Accuracy of Estimated Bioimpedance Parameters with Octapolar Segmental Bioimpedance Analysis

“…A cross-sectional study reported a significant positive correlation between the phase angle and fat-free mass (FFM) and significant differences in resistance and reactance between well-trained bodybuilders and healthy control individuals [ 6 , 8 ]. In clinical studies, BIA parameters have been reported as prognostic factors in patients with heart failure [ 15 , 16 , 17 ]. These findings suggest the association between raw impedance parameters and health, disease, and physical fitness, thereby increasing the interest in the clinical application of these parameters [ 6 , 18 , 19 , 20 , 21 ].…”

Plasma Levels of Intact Parathyroid Hormone and Congestion Burden in Heart Failure: Clinical Correlations and Prognostic Role

“…Indeed, LVEF, eGFR, and multiparametric score for congestion identification provide interesting prognostic insight in the evaluation of all-cause mortality in HF patients. Our group has already demonstrated the prognostic implication of creatinine clearance in patients with HF [ 38 ] as well as the impact of congestion in the overall mortality rate in these patients [ 25 ].…”

Usefulness of bioelectrical impedance analysis in assessment and monitoring of nutrition status of chronic heart failure patients

“…The work compared the use of various eGFR enumeration patterns (Donadio, Cockcroft-Gault, MDRD-4, CKD-EPI formula) for predicting all-cause mortality in CHF patients. Four hundred and thirty-six people with CHF were enrolled in the study, and the conclusions indicate that eGFR, calculated using the Donadio formula, was an independent predictor of mortality in patients with CHF, similar to the measures derived from the MDRD4 and CKD-EPI formulas, but less accurate than the Cockcroft-Gault formula [21].…”