Chronic renal disease in the general population. Importance of the absolute estimated glomerular giltration rate

  • Sergio Marinovich Instituto Integral de Nefrología, San Lorenzo, Santa Fe
  • Jorgelina Marinovich Laboratorio, Instituto Médico Regional, San Lorenzo, Santa Fe
  • María L. Benítez Instituto Integral de Nefrología, San Lorenzo, Santa Fe
  • Silvina Baldomá Laboratorio, Instituto Médico Regional, San Lorenzo, Santa Fe
  • Erica Dohle Instituto Integral de Nefrología, San Lorenzo, Santa Fe
  • Laura Del Basso Laboratorio, Instituto Médico Regional, San Lorenzo, Santa Fe
  • Rubén Cavoduro Instituto Integral de Nefrología, San Lorenzo, Santa Fe
  • Mariela Pérez Laboratorio, Instituto Médico Regional, San Lorenzo, Santa Fe
  • Griselda Nicola Instituto Integral de Nefrología, San Lorenzo, Santa Fe
  • Eduardo Gregorini Laboratorio, Instituto Médico Regional, San Lorenzo, Santa Fe
Keywords: chronic kidney disease, prevalence, estimated glomerular filtration rate, risk factors, urinary lithiasis, cancer

Abstract

Introduction: We assessed the prevalence of the Chronic Renal Disease (CRD) in the general population and the association with known risk factors. We determined the use of the absolute estimated glomerular filtration rate (absolute eGFR). Methods: We used the MDRD formula with 4 variables corrected for body surface area of the examined individual. The population with absolute eGFR < 60 mL/min was defined as “Likely CRD regardless proteinuria” and the latter plus the population with absolute eGFR = 60 mL/min presenting proteinuria = 30 mg/L was defined as “Likely CRD considering proteinuria”. Univariate and multivariate logistic regression to determine the association between absolute eGFR <60 mL/min with comorbid factors. Results: 811 individuals of an average age of 52.5 ± 17.0 years were examined. The rate of likely CRD without consideration of pathological proteinuria is 11.7% (95% CI:9.5 -14.3) while the rate considering this factor is 15.8% (95% CI:13.2 -18.8). The 3a group (absolute eGFR 45-59 mL/min) was the most frequent one: 9.9 % (95% CI:7.8 -12.3). The significant predictive factors for absolute eGFR <60 mL/min in the
multivariate model are: older age, past or current urinary lithiasis, female gender and history of neoplasia. The relative eGFR (mL/min/1.73m2) showed a likely CRD rate without consideration of proteinuria of 12.8% (95% CI: 10.48 -15.54), 1.1% higher than observed for absolute eGFR. Conclusions: The prevalence of potential CRD is high in Santa Fe. The older age, either past or current urinary lithiasis, female gender and history of neoplasia are associated with absolute eGFR <60 mL/min. Absolute eGFR helps to reduce the rate of likely CRD in 1.1%.

References

Inserra F, Cornelio C, Daverio S, Diehl, S, Samarelli N, Díaz A. Estratificación de la función renal de la población con cobertura social en la ciudad de Buenos Aires. Nefrol Argent. 2003,1:44.

Altobelli V, Elbert A, Pastore R, Gianzanti C, Galli B, Samson R, et al. Factores de riesgo de enfermedad renal crónica y cardiovascular en Salta [abstract]. Congreso Argentino de Nefrología (14°: 2005 : Iguazú).

Alles A, González M, González S, Torales S. Inducción de cambios en la conducta prescriptiva como política sanitaria para mejorar detección de

enfermedad renal oculta [abstract]. Nefrol Argent. 2011;9(2):96-7.

Marini A, Bacqué MC, De los Santos R, Dorado E, Wikinski R, Robaina J, et al. Relevamiento de factores de riesgo e indicadores de daño renal y cardiovascular en estudiantes de medicina. Rev Nefrol Dial Traspl. 2009;29(4):153-61.

Inserra F, De la Llave G, Alpino M, Castagna R, De la Fuente I, Dorado E, et al. Relevamiento de factores de riesgo y de enfermedad renal en familiares de pacientes en diálisis. Medicina (B Aires) 2007;67:8-18.

Rosa Diez G, Varela F, Crucelegui S, Algranati SL, Greloni G. Comparación entre las ecuaciones CKD-EPI y MDRD para la estimación del filtrado glomerular en pacientes con enfermedad renal crónica. Medicina (B Aires) 2011;71:323-30.

Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296-305.

Glassock RJ, Winearls C. Screening for CKD with eGFR: doubts and dangers. Clin J Am Soc Nephrol. 2008;3(5):1563-8.

Argentina. Instituto Nacional de Estadística y Censos. Censos 2001. Cuadro 12.4 Provincia por localidad, población por grupos de edad [Internet]. Buenos Aires: INDEC, 2001. Disponible en: http://www.indec.gob.ar/nivel4_default.asp?id_tema_1=2&id_tema_2=41&id_tema_3=134 [Consulta: enero 2013].

Argentina. Instituto Nacional de Estadística y Censos. Censos 2001. [Internet]. Buenos Aires: INDEC, 2001. Disponible en: http://www.indec.gob.ar/nivel4_default.asp?id_tema_1=2&id_tema_2=41&id_tema_3=134 [Consulta: enero 2013].

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-52.

Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253.

Levey AS, Green T, Kusek JW, Beck GJ. A simplified equation to predict glomerular filtration rate from serum creatinine [abstract]. J Am Soc Nephrol. 2000;11(suppl):A08028.

Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition. 1989;5(5):303-11.

National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(2 Suppl 1):S1-266.

American Diabetes Association. Standards of medical care in diabetes, 2011. Diabetes Care. 2011;34(Suppl 1):S11-61.

Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373-9.

Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298(17):2038-47.

Zhang QL, Rothenbacher D. Prevalence of chronic kidney disease in population-based studies: systematic review. BMC Public Health. 2008;8:117.

Otero A, de Francisco A, Gayoso P, García F; EPIRCE Study Group. Prevalence of chronic renal disease in Spain: results of the EPIRCE study. Nefrologia. 2010;30(1):78-86.

Jones GR. Estimating renal function for drug dosing decisions. Clin Biochem Rev. 2011;32(2):81-8.

Peral-Aguirregoitia J, Lertxundi-Etxebarria U, Saracho-Rotaeche R, Iturrizaga-Correcher S, Martínez-Bengoechea MJ. Estimating glomerular filtration rate in order to adjust drug doses: confusion abounds. Nefrologia. 2012;32(1):115-7.

Heras M, Fernández-Reyes MJ, Sánchez R, Guerrero MT, Molina A, Rodríguez MA, et al. Elderly patients with chronic kidney disease: outcomes after 5 years of follow-up. Nefrologia. 2012;32(3):300-5.

Snively CS, Gutierrez C. Chronic kidney disease: prevention and treatment of common complications. Am Fam Physician. 2004;70(10):1921-8.

Marinovich S, Lavorato C, Celia E, Bisigniano L, Soratti M, Krogh DH, et al. Registro Argentino de Diálisis Crónica 2009-2010. Informe 2011 [Internet]. Buenos Aires: Sociedad Argentina de Nefrología, Instituto Nacional Central Único Coordinador de Ablación e Implante, 2011. Disponible en: http://san.org.ar/docs/INTRODUCCION_MATERIAL_METODOS.pdf [Consulta: enero 2013].

Levey AS, Atkins R, Coresh J, Cohen EP, Collins AJ, Eckardt KU, et al. Chronic kidney disease as a global public health problem: approaches and initiatives - a position statement from Kidney Disease Improving Global Outcomes. Kidney Int. 2007;72(3):247-59.

Rule AD, Bergstralh EJ, Melton LJ 3rd, Li X, Weaver AL, Lieske JC. Kidney stones and the risk for chronic kidney disease. Clin J Am Soc Nephrol. 2009;4(4):804-11.

Alexander RT, Hemmelgarn BR, Wiebe N, Bello A, Morgan C, Samuel S, et al. Kidney stones and kidney function loss: a cohort study. BMJ. 2012;345:e5287.

Published
2017-09-05
How to Cite
1.
Marinovich S, Marinovich J, Benítez ML, Baldomá S, Dohle E, Del Basso L, Cavoduro R, Pérez M, Nicola G, Gregorini E. Chronic renal disease in the general population. Importance of the absolute estimated glomerular giltration rate. Rev Nefrol Dial Traspl. [Internet]. 2017Sep.5 [cited 2024Jul.16];33(1):4-15. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/173
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Original Article