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Comparison of three different creatinine clearance calculation methods in patients with type 2 diabetes mellitus

Year 2018, Volume:3 Issue: 3, 152 - 155, 30.11.2018
https://doi.org/10.25000/acem.434689

Abstract

Aim: To determine
the most accurate and useful method for calculating creatinine clearance by
comparing the results of different methods.

Methods: One hundred type
2 diabetic patients who have been followed by Okmeydani Training and Research
Hospital Internal Medicine and/or diabetes outpatient clinics were included in
this study. Individuals with hypertension, acute kidney disease and renal
transplantation were excluded from the study.

Results: Glomerular
filtration rate (GFR) calculated with Cockcroft-Gault formula was significantly
affected by creatinine, weight, and age
(p<0.050 for all). GFR measured with Modification of Diet in Renal Disease (MDRD)
formula was significantly
affected by creatinine and age (p<0.050 for all) in a univariate model; in a
multivariate model, this was significantly
independently affected by creatinine (p=0.001). GFR measured with 24h urine was significantly affected by
creatinine, weight, and age (p<0.050 for
all) in a univariate model; in a multivariate model,
this was significantly
independently affected by weight (p=0.001).







Conclusion: In
this study, those three methods revealed similar results. All of three methods
can be used for evaluating renal functions in Type II diabetic patients but
creatinine clearance with 24 hours urine method requires two patient visits in
a row and a more complex biochemistry laboratory; so in our opinion, this
method may be used as an alternative to the other two methods.

References

  • 1. King H, Auert RE, Herman WH. Global burden of diabetes, 1995- 2025:Prevalence, numerical estimates,and projections. Diabetes Care. 1998;219:1414-31.
  • 2. Howlett HCS, Bailey CJ. A risk-benefit assessment of metformin in type 2 diabetes mellitus. Drug Saf. 1999;20:489-503.
  • 3. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes—2018. American Diabetes Association. Diabetes Care. 2018; 41:S105-18.
  • 4. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002;25:1551-6.
  • 5. Mogensen CE, Christensen CK, Vittinghus E. The stages in diabetic renal disease. With an emphasis on the stage of incipient diabetic nephropathy. Diabetes. 1983;32:64-78.
  • 6. Cockroft DW, Gault MH. Prediction of Creatinine Clearance from serum creatinine Nephron. 1976;16:31-41.
  • 7. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A More Accurate to Estimate Glomerular Filtration Rate From Serum Creatinine; A New Prediction Equation. Ann Int Med. 1999;130:461-70.
  • 8. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Supp. 2013:1-150.
  • 9. Willems JM, Vlasveld T, den Elzen WP, Westendorp RG, Rabelink TJ, de Craen AJ et al. Performance of Cockcroft-Gault, MDRD, and CKD-EPI in estimating the prevalence of renal function and predicting survival in the oldest old. BMC Geriatrics. 2013;13:113.
  • 10. Teruel JL, Sabater J, Galeano C. The Cockcroft-Gault equation is better than MDRD equation to estimate the glomerular filtration rate in patients with advanced chronic renal failure. Nefrologia. 2007;27:313-9.
  • 11. Helou R. Should We Continue to Use the Cockcroft-Gault Formula? Nephron Clin Pract. 2010;116:172–86.
  • 12. Tiao JY, Semmens JB, Masarei JR, Lawrence-Brown MM. The effect of age on serum creatinine levels in an aging population: relevance to vascular surgery. Cardiovasc Surg. 2002;10:445-51.
  • 13. Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin J Am Soc Nephrol. 2010;5:1003-9.
  • 14. Rigalleau V, Lasseur C, Perlemoine C, Barthe N, Raffaitin C, Chauveau P et al. Cockcroft-Gault formula is biased by body weight in diabetic patients with renal impairment. Metabolism. 2006;55:108-12.
  • 15. Brown DL, Masselink AJ, Lalla CD. Functional range of creatinine clearance for renal drug dosing: a practical solution to the controversy of which weight to use in the Cockcroft-Gault equation. Ann Pharmacother. 2013;47:1039-44.
  • 16. Carter JL, Stevens PE, Irving JE, Lamb EJ. Estimating glomerular filtration rate: comparison of the CKD-EPI and MDRD equations in a large UK cohort with particular emphasis on the effect of age. QJM. 2011;104:839-47.

Tip 2 diyabetik bireylerde kreatinin klirensini hesaplamada kullanılan üç farklı yöntemin karşılaştırılması

Year 2018, Volume:3 Issue: 3, 152 - 155, 30.11.2018
https://doi.org/10.25000/acem.434689

Abstract

Amaç: Diyabetik
bireyler için kullanılabilecek en uygun kreatinin klirensi hesaplama metodunu
belirlemek amaçlandı.

Yöntem: Çalışmaya Okmeydanı
Eğitim Araştırma

Hastanesi

hastalıkları
ve diyabet polikliniklerine başvurmuş 100 tane tip 2
diyabetik hasta
dahil edildi. Hipertansiyon,
akut böbrek yetersizliği tanısı almış veya böbrek nakil alıcısı olan diyabetik
hastalar çalışma dışı bırakıldı.

Bulgular: Cockcroft-Gault
değerini kestirmede tek ve çok değişkenli modellerde yaş, ağırlık, kreatininin
anlamlı (hepsi için p<0,050) etkisi gözlenmiştir. MDRD değerini kestirmede
tek değişkenli modelde yaş, kreatininin; çok değişkenli modelde ise yalnızca kreatininin
anlamlı bağımsız (p=0,001) etkisi gözlenmiştir. 24 saatlik idrarda kreatinin
klirensi değerini kestirmede tek değişkenli modelde yaş, ağırlık, kreatinin
değerinin anlamlı (hepsi için p<0,050) etkisi gözlenmişken; çok değişkenli
modelde ise yalnızca ağırlık değerinin anlamlı bağımsız (p=0,001) etkisi
gözlenmiştir.







Sonuç: Bu çalışmada
üç yöntem de birbirleriyle uyumlu sonuç verdi.
Tip II diyabetik hastalarda böbrek fonksiyonlarını
değerlendirmek için üç yöntemin tamamı kullanılabilir, ancak 24 saatlik idrar
yöntemiyle kreatinin klirensi, üst üste iki hasta ziyareti ve daha karmaşık bir
biyokimya laboratuvarı gerektirir; bizim görüşümüze göre, bu yöntem diğer iki
yönteme alternatif olarak kullanılabilir.

References

  • 1. King H, Auert RE, Herman WH. Global burden of diabetes, 1995- 2025:Prevalence, numerical estimates,and projections. Diabetes Care. 1998;219:1414-31.
  • 2. Howlett HCS, Bailey CJ. A risk-benefit assessment of metformin in type 2 diabetes mellitus. Drug Saf. 1999;20:489-503.
  • 3. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes—2018. American Diabetes Association. Diabetes Care. 2018; 41:S105-18.
  • 4. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002;25:1551-6.
  • 5. Mogensen CE, Christensen CK, Vittinghus E. The stages in diabetic renal disease. With an emphasis on the stage of incipient diabetic nephropathy. Diabetes. 1983;32:64-78.
  • 6. Cockroft DW, Gault MH. Prediction of Creatinine Clearance from serum creatinine Nephron. 1976;16:31-41.
  • 7. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A More Accurate to Estimate Glomerular Filtration Rate From Serum Creatinine; A New Prediction Equation. Ann Int Med. 1999;130:461-70.
  • 8. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Supp. 2013:1-150.
  • 9. Willems JM, Vlasveld T, den Elzen WP, Westendorp RG, Rabelink TJ, de Craen AJ et al. Performance of Cockcroft-Gault, MDRD, and CKD-EPI in estimating the prevalence of renal function and predicting survival in the oldest old. BMC Geriatrics. 2013;13:113.
  • 10. Teruel JL, Sabater J, Galeano C. The Cockcroft-Gault equation is better than MDRD equation to estimate the glomerular filtration rate in patients with advanced chronic renal failure. Nefrologia. 2007;27:313-9.
  • 11. Helou R. Should We Continue to Use the Cockcroft-Gault Formula? Nephron Clin Pract. 2010;116:172–86.
  • 12. Tiao JY, Semmens JB, Masarei JR, Lawrence-Brown MM. The effect of age on serum creatinine levels in an aging population: relevance to vascular surgery. Cardiovasc Surg. 2002;10:445-51.
  • 13. Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin J Am Soc Nephrol. 2010;5:1003-9.
  • 14. Rigalleau V, Lasseur C, Perlemoine C, Barthe N, Raffaitin C, Chauveau P et al. Cockcroft-Gault formula is biased by body weight in diabetic patients with renal impairment. Metabolism. 2006;55:108-12.
  • 15. Brown DL, Masselink AJ, Lalla CD. Functional range of creatinine clearance for renal drug dosing: a practical solution to the controversy of which weight to use in the Cockcroft-Gault equation. Ann Pharmacother. 2013;47:1039-44.
  • 16. Carter JL, Stevens PE, Irving JE, Lamb EJ. Estimating glomerular filtration rate: comparison of the CKD-EPI and MDRD equations in a large UK cohort with particular emphasis on the effect of age. QJM. 2011;104:839-47.
There are 16 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Research
Authors

Fatih Orkun Kundaktepe

Mustafa Genco Erdem

Şerife Ayşen Helvacı This is me

Publication Date November 30, 2018
Published in Issue Year 2018 Volume:3 Issue: 3

Cite

Vancouver Kundaktepe FO, Erdem MG, Helvacı ŞA. Comparison of three different creatinine clearance calculation methods in patients with type 2 diabetes mellitus. Arch Clin Exp Med. 2018;3(3):152-5.