Document Detail


Applicability of estimated glomerular filtration rate in stratifying chronic kidney disease.
MedLine Citation:
PMID:  17454844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this audit was to evaluate the degree of glomerular filtration rate (GFR) among inpatients and outpatients in a District General Hospital, with special attention given to laboratory testing and impact on health delivery. BACKGROUND: UK Chronic Kidney Disease guidelines recommend that investigation of renal function should be accompanied by an estimation of GFR (eGFR) in order to identify and manage patients with chronic kidney disease (CKD). The estimated GFR forms the basis for classification of CKD and appropriate action plans for patient management and follow-up. METHOD: A retrospective audit of 8160 results from a predominantly British Caucasian population was carried out; extracting creatinine results from two isolated months in years 2001 and 2004. The estimated GFR (eGFR) was calculated using the MDRD formula. The data were classified according to demography, serum creatinine and eGFR. Patients from the 2001 database were classified according to eGFR and those with a value of <60 mL/min/1.73 m(2) were followed up in 2004. RESULTS: The difference in eGFR between the men and women was significantly different with medians (confidence intervals) of 80.1 (41-109) and 64.4 (30-84.6) (p<0.0001), respectively. There was an inverse association between age and eGFR in both genders (p<0.0001), with a decrease in eGFR of around 7 % for each decade increase in age. 1926 patients (24 %) of results studied had eGFR <60 mL/min, of whom 64 % were females and 36 % males. Follow-up of patients with eGFR<60 mL/min from 2001 showed that 4 % progressed to stages 4 and 5 CKD. CONCLUSION: eGFR is inversely associated with increasing age and female gender. MDRD derived eGFR fails to completely compensate for age and gender variations and thus different action limits may be required. Small but significant numbers of patients progressed to stages 4 and 5 CKD. Additional clarity in describing "progressive fall in eGFR" in the guidelines would improve identification of the population most at risk.
Authors:
Z Khatami; G Handley; K Narayanan; J U Weaver
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of clinical and laboratory investigation     Volume:  67     ISSN:  0036-5513     ISO Abbreviation:  Scand. J. Clin. Lab. Invest.     Publication Date:  2007  
Date Detail:
Created Date:  2007-04-24     Completed Date:  2007-08-30     Revised Date:  2008-08-21    
Medline Journal Info:
Nlm Unique ID:  0404375     Medline TA:  Scand J Clin Lab Invest     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  297-305     Citation Subset:  IM    
Affiliation:
Department of Biochemistry, Queens Hospital, Romford, Essex, UK. Zahra.khatami@BHRhospitals.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Creatinine / blood
Disease Progression
European Continental Ancestry Group
Female
Follow-Up Studies
Glomerular Filtration Rate*
Great Britain / epidemiology
Humans
Kidney Failure, Chronic / classification*,  epidemiology,  physiopathology*
Male
Middle Aged
Probability
Retrospective Studies
Sensitivity and Specificity
Sex Distribution
Chemical
Reg. No./Substance:
60-27-5/Creatinine
Comments/Corrections
Comment In:
Scand J Clin Lab Invest. 2008;68(3):254-5   [PMID:  17934971 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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