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author Luis-Lima, Sergio
Higueras Linares, Tomás
Henríquez-Gómez, Laura
Alonso-Pescoso, Raquel
Jimenez, Angeles
López-Hijazo, Asunción María
Negrín-Mena, Natalia
Martín, Candelaria
Sánchez-Gallego, Macarena
Galindo-Hernández, Sara Judith
Socas Fernández del Castillo, Raquel
Castilla-Marrero, Manuel
Domínguez-Coello, Santiago
Vilchez de León, Vanesa
Valcárcel-Lopez, Rafael
Insausti-Garmendia, Nerea
Escamilla, Beatriz
Estupiñán, Sara
Delgado-Mallén, Patricia
Armas-Padrón, Ana-María
Marrero-Miranda, Domingo
González-Rinne, Ana
Miquel Rodríguez, Rosa María
Cobo-Caso, María Angeles
Díaz-Martín, Laura
González-Rinne, Federico
González-Delgado, Alejandra
López-Martínez, Marina
Jiménez-Sosa, Alejandro
Torres, Armando
Porrini, Esteban
author_facet Luis-Lima, Sergio
Higueras Linares, Tomás
Henríquez-Gómez, Laura
Alonso-Pescoso, Raquel
Jimenez, Angeles
López-Hijazo, Asunción María
Negrín-Mena, Natalia
Martín, Candelaria
Sánchez-Gallego, Macarena
Galindo-Hernández, Sara Judith
Socas Fernández del Castillo, Raquel
Castilla-Marrero, Manuel
Domínguez-Coello, Santiago
Vilchez de León, Vanesa
Valcárcel-Lopez, Rafael
Insausti-Garmendia, Nerea
Escamilla, Beatriz
Estupiñán, Sara
Delgado-Mallén, Patricia
Armas-Padrón, Ana-María
Marrero-Miranda, Domingo
González-Rinne, Ana
Miquel Rodríguez, Rosa María
Cobo-Caso, María Angeles
Díaz-Martín, Laura
González-Rinne, Federico
González-Delgado, Alejandra
López-Martínez, Marina
Jiménez-Sosa, Alejandro
Torres, Armando
Porrini, Esteban
author_sort Luis-Lima, Sergio
collection PubMed
description Type 2 diabetes mellitus represents 30–50% of the cases of end stage renal disease worldwide. Thus, a correct evaluation of renal function in patients with diabetes is crucial to prevent or ameliorate diabetes-associated kidney disease. The reliability of formulas to estimate renal function is still unclear, in particular, those new equations based on cystatin-C or the combination of creatinine and cystatin-C. We aimed to assess the error of the available formulas to estimate glomerular filtration rate in diabetic patients. We evaluated the error of creatinine and/or cystatin-C based formulas in reflecting real renal function over a wide range of glomerular filtration rate (from advanced chronic kidney disease to hyperfiltration). The error of estimated glomerular filtration rate by any equation was common and wide averaging 30% of real renal function, and larger in patients with measured glomerular filtration rate below 60 mL/min. This led to chronic kidney disease stages misclassification in about 30% of the individuals and failed to detect 25% of the cases with hyperfiltration. Cystatin-C based formulas did not outperform creatinine based equations, and the reliability of more modern algorithms proved to be as poor as older equations. Formulas failed in reflecting renal function in type 2 diabetes mellitus. Caution is needed with the use of these formulas in patients with diabetes, a population at high risk for kidney disease. Whenever possible, the use of a gold standard method to measure renal function is recommended.
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spelling pubmed-68323802019-11-21 The Error of Estimated GFR in Type 2 Diabetes Mellitus Luis-Lima, Sergio Higueras Linares, Tomás Henríquez-Gómez, Laura Alonso-Pescoso, Raquel Jimenez, Angeles López-Hijazo, Asunción María Negrín-Mena, Natalia Martín, Candelaria Sánchez-Gallego, Macarena Galindo-Hernández, Sara Judith Socas Fernández del Castillo, Raquel Castilla-Marrero, Manuel Domínguez-Coello, Santiago Vilchez de León, Vanesa Valcárcel-Lopez, Rafael Insausti-Garmendia, Nerea Escamilla, Beatriz Estupiñán, Sara Delgado-Mallén, Patricia Armas-Padrón, Ana-María Marrero-Miranda, Domingo González-Rinne, Ana Miquel Rodríguez, Rosa María Cobo-Caso, María Angeles Díaz-Martín, Laura González-Rinne, Federico González-Delgado, Alejandra López-Martínez, Marina Jiménez-Sosa, Alejandro Torres, Armando Porrini, Esteban J Clin Med Article Type 2 diabetes mellitus represents 30–50% of the cases of end stage renal disease worldwide. Thus, a correct evaluation of renal function in patients with diabetes is crucial to prevent or ameliorate diabetes-associated kidney disease. The reliability of formulas to estimate renal function is still unclear, in particular, those new equations based on cystatin-C or the combination of creatinine and cystatin-C. We aimed to assess the error of the available formulas to estimate glomerular filtration rate in diabetic patients. We evaluated the error of creatinine and/or cystatin-C based formulas in reflecting real renal function over a wide range of glomerular filtration rate (from advanced chronic kidney disease to hyperfiltration). The error of estimated glomerular filtration rate by any equation was common and wide averaging 30% of real renal function, and larger in patients with measured glomerular filtration rate below 60 mL/min. This led to chronic kidney disease stages misclassification in about 30% of the individuals and failed to detect 25% of the cases with hyperfiltration. Cystatin-C based formulas did not outperform creatinine based equations, and the reliability of more modern algorithms proved to be as poor as older equations. Formulas failed in reflecting renal function in type 2 diabetes mellitus. Caution is needed with the use of these formulas in patients with diabetes, a population at high risk for kidney disease. Whenever possible, the use of a gold standard method to measure renal function is recommended. MDPI 2019-09-26 /pmc/articles/PMC6832380/ /pubmed/31561432 http://dx.doi.org/10.3390/jcm8101543 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Luis-Lima, Sergio
Higueras Linares, Tomás
Henríquez-Gómez, Laura
Alonso-Pescoso, Raquel
Jimenez, Angeles
López-Hijazo, Asunción María
Negrín-Mena, Natalia
Martín, Candelaria
Sánchez-Gallego, Macarena
Galindo-Hernández, Sara Judith
Socas Fernández del Castillo, Raquel
Castilla-Marrero, Manuel
Domínguez-Coello, Santiago
Vilchez de León, Vanesa
Valcárcel-Lopez, Rafael
Insausti-Garmendia, Nerea
Escamilla, Beatriz
Estupiñán, Sara
Delgado-Mallén, Patricia
Armas-Padrón, Ana-María
Marrero-Miranda, Domingo
González-Rinne, Ana
Miquel Rodríguez, Rosa María
Cobo-Caso, María Angeles
Díaz-Martín, Laura
González-Rinne, Federico
González-Delgado, Alejandra
López-Martínez, Marina
Jiménez-Sosa, Alejandro
Torres, Armando
Porrini, Esteban
The Error of Estimated GFR in Type 2 Diabetes Mellitus
title The Error of Estimated GFR in Type 2 Diabetes Mellitus
title_full The Error of Estimated GFR in Type 2 Diabetes Mellitus
title_fullStr The Error of Estimated GFR in Type 2 Diabetes Mellitus
title_full_unstemmed The Error of Estimated GFR in Type 2 Diabetes Mellitus
title_short The Error of Estimated GFR in Type 2 Diabetes Mellitus
title_sort error of estimated gfr in type 2 diabetes mellitus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832380/
https://www.ncbi.nlm.nih.gov/pubmed/31561432
http://dx.doi.org/10.3390/jcm8101543
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