Comparación entre las ecuaciones CKD-EPI y MDRD para la estimación del filtrado glomerular en pacientes con enfermedad renal crónica

Comparison between CKD-EPI and MDRD-equations to estimate glomerular filtration rate in chronic kidney disease patients. TheMDRDequationtoestimateglomerularfiltrationrate�(GFR)� isthemostwidelyusedstrategytoassesschronickidneydisease.�Nonetheless,�fortheindividualpatientthetrue� GFRcanbeunderestimatedwiththeriskofdiagnosingamoreelevatedCKDstage.�ThisnovelCKD-EPIequation� wouldimproveaccuracyandprecisionofestimations,�andseveralauthorsrecommendthisnewequationreplace� theformer.�Inourcountrythereisonlyalimitedregistrationofthesecomparisonsperformedonalargenumberof� patients.�Therefore,�ouraimwastodevelopacomparisoninawidecohortofpatients.�Theconcordancebetween� bothequationstoassigntheGFRstageswasdeterminedbyusingtheMDRDformulaasareference.�Themean� differenceofGFRobtainedwithbothequationsaswellastheBland-Altmananalysiswerecalculated.�Acohort� of�9�319�individuals,�ofwhom�67%�werefemales,�aged�58�±�20�years,�withserumcreatininevaluesof�1.6�±�1.03� mg/dl,�wasstudied.�Inthewholegroup,�CKD-EPIdisplayedanaverageGFR�0.61�ml/min/1.73�m 2 �largerthan� MDRD�(p:�NS).�ForCKDstages�2�and�3AthemeanestimatedGFRdifferencewas�6.95�±�4.76�and�3.21�±�3.31,� whiletheconcordancewas�81�and�74%�respectively.�ThepercentageofpatientswithGFR�<�60�ml/min/1.73�m2,� decreasedfrom�76.3%�withtheformerequationto�70.1%�withthelatter.�ThenovelequationCKD-EPIreduces� thenumberofpatientswithGFRvalueslowerthan�60�ml/min/1.73�m2�andconsequentlyassignsahigherGFR�