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Serum Creatinine versus Corrected Cockcroft-Gault Equation According to Poggio Reference Values in Patients with
Damir Šečić1, Adnan Turohan2, Edin Begić3,4
1Department of Pathophysiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Insights
Serum creatinine is an insensitive marker for kidney function. A corrected Cockcroft-Gault (CG) formula, accounting for body surface area (BSA) and BMI, provides a more accurate estimation of glomerular filtration rate (GFR) in hypertension patients.
Area of Science:
- Nephrology
- Cardiology
- Clinical Chemistry
Background:
- Serum creatinine is a common but insensitive marker for evaluating glomerular filtration rate (GFR).
- The Cockcroft-Gault (CG) formula is frequently used for GFR estimation but requires corrections for body surface area (BSA), adiposity (BMI), and tubular secretion.
- Accurate GFR assessment is crucial for managing patients with arterial hypertension.
Purpose of the Study:
- To compare renal function estimation using serum creatinine versus a corrected CG equation in patients with arterial hypertension.
- To evaluate the impact of BSA, BMI, and tubular secretion corrections on GFR estimation.
- To determine if the corrected CG equation improves early diagnosis of renal dysfunction in hypertensive individuals.
Main Methods:
- Included 124 male and female patients with arterial hypertension, excluding those with pre-existing chronic kidney disease.
- Estimated creatinine clearance and GFR using the CG method, applying corrections for BSA, BMI, and creatinine tubular secretion.
- Compared results against Poggio reference values based on biological parameters (age, gender).
Main Results:
- No significant difference was found between serum creatinine and CG-estimated creatinine clearance (corrected for BMI, BSA) in physiological vs. pathological renal function groups.
- A significant difference was observed between serum creatinine and CG-estimated GFR (corrected for BMI, BSA, and tubular secretion) in physiological vs. pathological renal function groups.
- The most notable discrepancy in renal function assessment was between serum creatinine and the triple-corrected CG-estimated GFR.
Conclusions:
- The triple-corrected CG equation (BSA, BMI, tubular secretion) offers a more sensitive assessment of renal function compared to serum creatinine alone.
- This enhanced GFR estimation method can aid in the early diagnosis of renal dysfunction in patients with arterial hypertension.
- Optimized GFR assessment facilitates timely and effective treatment strategies for hypertensive patients with potential kidney issues.
Introduction:
Serum creatinine is not enough sensitive marker for the evaluation of glomerular filtration rate (GFR). Cockcroft-Gault (CG) formula is often used to assess GFR, but it is necessary to correct original one for body surface area (BSA), adipositas, and the creatinine tubular secretion. The values of the estimated creatinine clearance and GFR are considered to Poggio reference ones according to biological parameters (age and gender). The aim of the study was to determine the difference in renal function estimation between serum creatinine and corrected CG equation according to the Poggio reference values in the arterial hypertension patients.
Materials And Methods:
The research included 124 patients of both gender with arterial hypertension, excluding ones with the already verified chronic kidney disease. We estimated creatinine clearance and GFR by CG method corrected for the BSA, body mass index (BMI), and the creatinine tubular secretion according to Poggio reference values.
Results:
There was no significant difference in both age and gender groups among patients with physiological and pathological values of the renal function determined by the serum creatinine and estimated creatinine clearance by CG equation corrected for BMI, BSA. In both age and gender groups there was significant difference among subjects with physiological and pathological values of the renal function determined by serum creatinine and estimated GFR by CG method corrected for BMI, BSA, and creatinine tubular secretion.
Conclusion:
There is the most striking difference in the assessment of renal function between serum creatinine and estimated GFR by CG method with three corrections (BSA, BMI, the creatinine tubular secretion). Estimated GFR by CG method with three corrections can help in the early diagnosis of renal dysfunction and optimal treatment in patients with arterial hypertension.
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