| Abstract | Prema vodećim smjernicama preporučena jednadžba za procjenu glomerularne filtracije (engl. estimated glomerular filtration rate, eGFR) je CKD-EPI jednadžba koja je prilagođena za površinu tijela (engl. body surface area, BSA) od 1,73 m2. Cilj ove studije bio je usporediti eGFR CKD EPI jednadžbu prilagođenu na 1,73 m2 s CKD-EPI jednadžbama izračunatim prilagodbom realnoj površini tijela izračunatoj s DuBoisovom i Moestellerovom jednadžbom. U istraživanje je bilo uključeno 2058 ispitanika (prosječna dob 50,09 godina, 60,16% žena). eGFR je izračunata pomoću CKD-EPI izražene za prosječnu BSA 1,73m2 te s de-indeksrianom CKD-EPI jednadžbama koja su koristile srednje vrijednosti BSA svih ispitanika (dobivene pomoću DuBois i Moesteller jednadžbi, CKD-DB i CKD-M) i individualne vrijednosti BSA (CKD-DBi i CKD-Mi). Vrijednost prosječne BSA u ukupnoj populaciji izračunata s DuBois bila je 1,87 ± 0,21 m2, a s Moesteller 1,90 ± 0,22 m2, (p<0,0001). Prosječna vrijednost eGFR primjenom CKD-EPI iznosila je 85,89 ± 19,14 ml/min/1,73m2. Prosječna vrijednost eGFR dobivena s CKD-DB i CKD-M iznosila je 92,84 ± 20,69 ml/min/1,87m2 i 94,33 ± 21,03 ml/min/1,90m2, (p<0,0001) te s CKD-DBi i CKD-Mi, 93,65 ± 22,43 ml/min i 94,96 ± 22,70 ml/min, (p<0,0001). Uočili smo značajne razlike u prevalenciji kronične bubrežne bolesti i pojedinih stadija između CKD EPI i deindeksiranih jednadžbi što je naročito bilo izraženo u pretilih osoba. CKD EPI jednadžba nije pouzdana niti u dijagnostici glomerularnih hiperfiltratora i na temelju naših rezultata možemo predložiti korištenje deindeksiranih jednadžbi umjesto CKD EPI u općoj populaciji, a naročito u pretilih ispitanika. |
| Abstract (english) | The recommendation for calculation of eGFR is using the CKD-EPI equation which is adjusted for unique body surface area (BSA) of 1.73 m2. The aim of this study was to compare CKD-EPI eGFR with de-indexed CKD-EPI equation using specific BSA calculated with DuBois and Moesteller equations. In total we included 2058 subjects (average age 50.09 yr, 60.16% females). eGFR was calculated using CKD-EPI expressed for an average BSA of 1.73m2 and with de-indexed CKD-EPI using the mean BSA of the group (calculated with DuBois and Moesteller, CKD-DB and CKD-M) and individual BSA (CKD- DBi and CKD-Mi). The value of average BSA in total population calculated with DuBois was 1.87 ± 0.21m2 and Moesteller 1.90 ± 0.22m2, (p<0.0001). Average eGFR using CKD-EPI was 85.89 ± 19.14 ml/min/1.73m2. The average eGFR calculated with CKD-DB and CKD-M was 92.84 ± 20.69 ml/min/1.87m2 and 94.33 ± 21.03 ml/min/1.90m2, respectively (p<0.0001), also with CKD-DBi and CKD-Mi, 93.65 ± 22.43 ml/min, 94.96 ± 22.70 ml/min, respectively (p<0.0001). Significant difference in prevalence of chronic kidney disease (CKD) and difference in distribution of CKD stages were observed when eGFR was estimated using CKD EPI equation and de-indexed equations. This was particularly obvious in overweight and obese subjects. Based on our results we could propose de-indexed equations to be used instead of CKD EPI in obese and overweight populations. |
