Comments on the comparison and agreement of equations to estimate glomerular filtration rate in diagnosis of occult chronic kidney disease
Comentarios a la comparación y concordancia de las ecuaciones de estimación de filtrado glomerular en el diagnóstico de enfermedad renal crónica oculta
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=> array:12 [ "idiomaDefecto" => true "titulo" => "Comments on the comparison and agreement of equations to estimate glomerular filtration rate in diagnosis of occult chronic kidney disease" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "561" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Pedro Jesús Labrador Gómez, Petra González Castillo, Teresa Mengotti Fernández de los Ríos, Alvaro Montaña Jiménez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Pedro Jesús" "apellidos" => "Labrador Gómez" "email" => array:1 [ 0 => "pjlabrador@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Petra" "apellidos" => "González Castillo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "nombre" => "Teresa" "apellidos" => "Mengotti Fernández de los Ríos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "nombre" => "Alvaro" "apellidos" => "Montaña Jiménez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Unidad de Nefrología, Hospital Virgen del Puerto, Plasencia, Cáceres, España, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comentarios a la comparación y concordancia de las ecuaciones de estimación de filtrado glomerular en el diagnóstico de enfermedad renal crónica oculta" ] ] "textoCompleto" => "To the editor: From the greatest respect to the study conducted by Buitrago et al1 comparing the agreement between different equations to estimate glomerular filtration rate (GFR), we would like to make some comments: <br></br><br></br>1. Buitrago et al conclude that the MDRD equation would exclude from diagnosis of chronic kidney disease (CKD) a group of people with a high cardiovascular risk who would be diagnosed using the Cockcroft-Gault (CG) equation, and that follow-up of such people found a similar proportion of coronary and cardiovascular events as in the group of patients with CKD according to the MDRD equation. This result agrees with recommendations of European guidelines for management of arterial hypertension,2 which consider renal subclinical lesion the presence of a decreased GFR both by the MDRD and CG equations. <br></br><br></br>2. If the number of patients with occult CKD detected by each of the two equations in the study is analyzed, both the CG and MDRD equations would detect 50 of 118 patients (42.4%). The remaining patients would be diagnosed based on one of the equations used. Thus, 70 of the 118 patients (59.3%) would be detected by the CG equation, and 98 patients (83.1%) would be detected by the MDRD equation The MDRD equation detects almost 25% more patients who experienced 17% of coronary events and 22% of cardiovascular events in a 10-year follow-up period. The MDRD equation may be considered more effective for detecting the population at risk in such group. <br></br><br></br>3. Moreover, the MDRD equation may be automatically implemented in the operating system of laboratories with no additional cost, whereas each calculation of the CG equation requires manual entry of the patient weight, as well as height if we want to subsequently correct it for body surface area, as was done in the above study. This makes the MDRD equation more efficient. <br></br><br></br>4. In the study, reporting test data from patients collected between 1990 and 1994, no reference is made to whether serum creatinine levels measured in mg/dL were rounded to one or two decimals. This has a special relevance when studies on the prevalence of CKD are performed. Our group recently reported3 that when a single decimal was used in our population for establishing diagnosis of CKD, prevalence increased 9%, while diagnosis of occult CKD decreased 26%. This decrease was much greater in males as compared to females. <br></br><br></br>Thus, and in agreement with the consensus document from the Spanish Society of Nephrology and the Society of <br></br>Clinical Chemistry,4 we think that the MDRD equation is more effective and efficient than the CG equation, and its use should be implemented in laboratory reports. <br></br>" "pdfFichero" => "P-E-S-A365-EN.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "To the editor: From the greatest respect to the study conducted by Buitrago et al1 comparing the agreement between different equations to estimate glomerular filtration rate (GFR), we would like to make some comments:" ] "es" => array:1 [ "resumen" => "Desde el mayor respeto al trabajo realizado por Buitrago y cols.1 donde se compara la concordancia entre distintas ecuaciones de estimación del filtrado glomerular (FG) quisiéramos realizar una serie de comentarios: " ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "1.- Buitrago J, Calvo JI, Gómez-Jiménez C, Cañón L, Robles NR, Angulo E. Comparación y concordancia de las ecuaciones de estimación de filtrado glomerular de Cockcroft-Gault y MDRD en el diagnóstico de enfermedad renal crónica oculta. Nefrología 2008; 28: 301-310. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18590497" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "2.- Mancia G, de Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AV, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope LM, Rynkiewicz A, Schmieder RE, Struijker HAJ, Zanchetti A. 2007 Guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of Hypertension 2007; 25: 1105-1187. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17563527" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "3.- Labrador PJ, Jiménez M, Mengotti T, Labrador J. Enfermedad renal oculta. Una cuestión de decimales. Nefrología 2008; 28: 228-229. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18454721" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "4.- Gracia S, Montañes R, Bover J, Cases A, Deulofeu R, de Francisco ALM, Orte LM. Documento de consenso: recomendaciones sobre la utilización de ecuaciones para la estimación del filtrado glomerular en adultos. Nefrología 2006: 26: 658-665. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17227242" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002800000005/v0_201502091635/X2013251408004163/v0_201502091635/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002800000005/v0_201502091635/X2013251408004163/v0_201502091635/en/P-E-S-A365-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004163?idApp=UINPBA000064" ]
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