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Estimated glomerular filtration rate based on creatinine, cystatin C, ß-trace protein and ß2 microglobulin in patients undergoing nontraumatic lower extremity amputation.
Iversen, Esben; Walls, Anne Byriel; Petersen, Annamarie; Jensen, Pia Søe; Kallemose, Thomas; Andersen, Aino; Nielsen, Rikke Lundsgaard; Bengaard, Anne Kathrine; Juul-Larsen, Helle Gybel; Bornaes, Olivia; Damgaard, Morten; Andersen, Ove; Tavenier, Juliette; Houlind, Morten Baltzer.
Afiliación
  • Iversen E; Department of Clinical Research, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
  • Walls AB; Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
  • Petersen A; The Capital Region Pharmacy, Herlev, Denmark.
  • Jensen PS; Department of Clinical Research, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
  • Kallemose T; Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
  • Andersen A; The Capital Region Pharmacy, Herlev, Denmark.
  • Nielsen RL; Department of Clinical Research, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
  • Bengaard AK; The Research Unit of Orthopedic Nursing, Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
  • Juul-Larsen HG; Department of Clinical Research, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
  • Bornaes O; Department of Clinical Research, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
  • Damgaard M; Department of Clinical Research, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
  • Andersen O; Department of Clinical Research, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark.
  • Tavenier J; The Capital Region Pharmacy, Herlev, Denmark.
  • Houlind MB; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Br J Clin Pharmacol ; 89(6): 1789-1798, 2023 06.
Article en En | MEDLINE | ID: mdl-36511684
ABSTRACT

AIMS:

The study's aim is to compare current and new equations for estimating glomerular filtration rate (GFR) based on creatinine, cystatin C, ß-trace protein (BTP) and ß2 microglobulin (B2M) among patients undergoing major amputation.

METHODS:

This is a secondary analysis of data from a prospective cohort study investigating patients undergoing nontraumatic lower extremity amputation. Estimated GFR (eGFR) was calculated using equations based on creatinine (eGFRcre[2009] and eGFRcre[2021]), cystatin C (eGFRcys), the combination of creatinine and cystatin C (eGFRcomb[2012] and eGFRcomb[2021]) or a panel of all 4 filtration markers (eGFRpanel). Primary outcome was changed in eGFR across amputation according to each equation. Two case studies of prior amputation with GFR measured by 99mTc-DTPA clearance are described to illustrate the relative accuracies of each eGFR equation.

RESULTS:

Analysis of the primary outcome included 29 patients (median age 75 years, 31% female). Amputation was associated with a significant decrease in creatinine concentration (-0.09 mg/dL, P = 0.004), corresponding to a significant increase in eGFRcre[2009] (+6.1 mL/min, P = 0.006) and eGFRcre[2021] (+6.3 mL/min, P = 0.006). Change across amputation was not significant for cystatin C, BTP, B2M or equations incorporating these markers (all P > 0.05). In both case studies, eGFRcre[2021] yielded the largest positive bias, eGFRcys yielded the largest negative bias and eGFRcomb[2012] and eGFRcomb[2021] yielded the smallest absolute bias.

CONCLUSION:

Creatinine-based estimates were substantially higher than cystatin C-based estimates before amputation and significantly increased across amputation. Estimates combining creatinine and cystatin were stable across amputation, while the addition of BTP and B2M is unlikely to be clinically relevant.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Extremidad Inferior / Cistatina C Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Br J Clin Pharmacol Año: 2023 Tipo del documento: Article País de afiliación: Dinamarca

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Extremidad Inferior / Cistatina C Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Br J Clin Pharmacol Año: 2023 Tipo del documento: Article País de afiliación: Dinamarca