La ecuación CKD-EPI es la más fiable para estimar la función renal en pacientes con lupus eritematoso sistémico

Martínez-Martínez, Marco U.; Martínez-Martínez, Marco Ulises; Mandeville, Peter; Llamazares-Azuara, Lilia; Llamazares-Azuara, Lilia; Abud-Mendoza, Carlos

doi:10.3265/Nefrologia.pre2012.Jun.11101

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Antecedentes: Ningún estudio ha podido determinar cuál es la mejor ecuación para calcular la función renal en pacientes con lupus eritematoso sistémico (LES) partiendo del análisis de una evaluación de referencia. Objetivo: Evaluar el rendimiento de las ecuaciones basadas en cistatina/creatinina en la estimación de la función renal en pacientes con LES. Métodos: Realizamos el estudio en dos fases: la primera incluía 14 pacientes en los que el aclaramiento de yotalamato se utilizó para determinar la tasa de filtración glomerular (FG) y se comparó con diferentes ecuaciones basadas en cistatina C y/o creatinina En la segunda fase, utilizamos la mejor ecuación (basada en cistatina y creatinina) como «estándar de referencia» para comparar 5 ecuaciones basadas en creatinina en 55 pacientes con LES. Resultados: En la primera fase, la ecuación desarrollada por Stevens et al. (basada en creatinina y cistatina C) fue considerada la mejor. En la fase dos, la ecuación CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) fue considerada la mejor con una desviación de –2,1 ml/min/1,73, exactitud (P30 %) del 94,5 % y precisión (rango intercuartílico de las diferencias ) de –2,1 ml/min/1,73. Conclusiones: Nuestros datos sugieren que la ecuación CKD-EPI es la mejor ecuación basada en creatinina para estimar la FG en pacientes con LES.

Palabras clave:

Ecuaciones de estimación del filtrado glomerular

Palabras clave:

Lupus eritematoso sistémico

Palabras clave:

Tasa de filtración glomerular

Background: No study has determined the best equation for estimating renal function in patients with systemic lupus erythematosus (SLE), starting from a gold standard test. Objective: To evaluate the performance of cistatin/creatinine based equations for estimating renal function in patients with SLE. Methods: We conducted two phases: the first phase included 14 patients in which iothalamate clearance was used to determine the glomerular filtration rate (GFR) and compared with different equations based on cystatin C and/or creatinine. In the second phase, we used the best equation (a cystatin and creatinine-based equation) as “reference standard” to compare 5 creatinine-based equations in 55 patients with SLE. Results: In the first phase the equation developed by Stevens and colleagues (based on creatinine and cystatin C), was the best equation. In phase 2, the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation was the best equation with bias of -2.1ml/min/1.73, accuracy (P30) of 94.5% and precision (interquartile range of differences) of -2.1 ml/min/1.73. Conclusions: Our data suggest that CKD-EPI is the best creatinine-based equation to estimate GFR in patients with SLE.

Keywords:

Equations

Keywords:

Systemic erythematosus lupus

Keywords:

Glomerular filtration rate

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