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The HUGE formula (hematocrit, urea and gender): association with cardiovascular risk
N R Robles1, F J Felix, D Fernandez-Berges
1University of Salamanca, Salamanca, Spain. nrrobles@yahoo.es
Insights
The HUGE formula effectively identifies chronic renal failure (CRF) and its associated cardiovascular risk, outperforming MDRD-4 in this study. This simple tool aids in diagnosing CRF and assessing patient cardiovascular risk.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of mortality.
- Chronic renal failure (CRF) is an independent risk factor for CVD.
- Accurate identification of CRF is crucial for cardiovascular risk stratification.
Purpose of the Study:
- To assess the relationship between CRF, identified using the HUGE formula (hematocrit, urea, and gender), and cardiovascular risk.
- To compare the diagnostic utility of the HUGE formula with estimated glomerular filtration rate (eGFR) using the MDRD-4 equation for predicting cardiovascular risk.
Main Methods:
- A cross-sectional study of 2,831 subjects.
- HUGE score calculated using hematocrit, urea, and gender.
- Glomerular filtration rate (GFR) estimated using the abbreviated Modification of Diet in Renal Disease (MDRD-4) equation.
- Cardiovascular disease antecedents (ischemic cardiopathy, cerebrovascular disease, peripheral arterial disease) were analyzed.
Main Results:
- The HUGE formula identified CRF in 2.2% of subjects, with 19.7% having a history of cardiovascular disease.
- The MDRD-4 equation identified CRF in 4.0% of subjects, with 15.9% having a history of cardiovascular disease.
- The odds ratio for cardiovascular disease using the HUGE definition of CRF was 3.25 (p = 0.001). CRF was associated with higher pulse pressure and increased urinary albumin excretion.
Conclusions:
- The HUGE formula is a valuable tool for diagnosing CRF and assessing cardiovascular risk.
- CRF diagnosed by the HUGE formula shows a significant association with cardiovascular risk.
- This association is stronger than that observed with MDRD-4 eGFR, despite a larger sample size for MDRD-4.
Objectives:
To evaluate the relationship between chronic renal failure (CFR) defined through HUGE (hematocrit, urea and gender) formula score and the patient's cardiovascular risk measured through cardiovascular disease antecedents such as ischemic cardiopathy, cerebrovascular disease and peripheral arterial disease.
Design And Methods:
The sample consisted of 2,831 subjects. Mean age was 51.2±14.7 years and 53.5% were female. Serum creatinine, urea, hematocrit and 24h proteinuria were analyzed. HUGE score was calculated from gender, urea and hematocrit. GFR was estimated from uncalibrated serum creatinine using the abbreviated Modification of Diet in Renal Disease equation (MDRD-4). UAE was measured in first morning urine sample.
Results:
Using HUGE formula 2.2% (n = 61) of subjects had CRF. Of them, 12 (19.7%) had cardiovascular disease history. Among patients without CRF (n = 2770), 194 subjects had history of previous cardiovascular diseases (0.07%; p < 0.001 Square Chi test). Using the MDRD-4 formula 4.0% of subjects (n = 113) had a GFR < 60 ml/min. Of them, 18 (15.9%) had cardiovascular disease history. Among patients without CRF (n = 2718), 188 subjects had history of previous cardiovascular diseases (0.07%; p < 0.001 Square Chi test). Odd's ratio for cardiovascular diseases using HUGE definition of CRF was 3.25 (p = 0.001, Mantel-Haenszel test). CFR was associated to higher pulse pressure (PP) and increased urinary albumin excretion.
Conclusions:
A significant cardiovascular risk was associated to the diagnosis of CRF through HUGE formula. This relation was closer than the obtained using MDRD estimated GFR in spite of a bigger sample. HUGE formula seems to be a useful tool for diagnosing CRF and evaluate the cardiovascular risk of these patients.
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