Estimates of glomerular filtration rate based on creatinine and cystatin c equations in critically ill patients

Mohd Hanafiah, Farah Nadia and Md Ralib, Azrina and Abd Hadi Mohamed, Rozilah and Ramly, Nur Fariza and Abd Rahim, Mohd Shahrir (2021) Estimates of glomerular filtration rate based on creatinine and cystatin c equations in critically ill patients. In: 4th Kuantan Research Day 2020, Virtual.

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Abstract

Introduction and Aim: Accurate assessment of renal function in the critically ill is a complex task. Estimated glomerular filtration rate (eGFR) is the best indicator to help physicians estimate kidney function and determine different stages of kidney disease. eGFR can be calculated using serum Creatinine (SCr), or serum Cystatin C (SCysC), age, body size, race and gender using different equations. We evaluated eGFR based on SCr and SCysC equations in critically ill patients to find an accurate, precise, and less biased equation for GFR estimation. Methods: This is a single cantered, cross-sectional observational study in critically ill patients older than 18 years staying for over 24-hours in intensive care units. Urinary Creatinine, SCr, and SCysC were measured at 8, 24, and 72-hour intervals. Acute kidney injury (AKI) was defined at admission using the Creatinine definition of the Kidney Disease Improving Global Outcome (KDIGO) guideline. After estimating GFR from Creatinine (eGFRCr), Cystatin C (eGFRCysC), and combining Creatinine and Cystatin C (eGFRCr-CysC), results were compared with measured Creatinine clearance (CrCL). CrCL was defined based on urinary Creatinine, SCr, and urinary volume in a 24-hour period. Results: Forty-three patients were recruited, of which 6 died and 37 alive. eGFRCr-24hrs had the highest correlation to measured CrCL-24hrs, with correlation coefficient of 0.81 (p<0.001). eGFRCr-72hrs had the highest accuracy at 30% and 50% of measured CrCL between 57.69% and 69.23% respectively. However, the eGFRCysC-24hrs equation was more precise with the lowest bias of 0.94. Logisticregression-analysis reveals that p values for eGFRCr-24hrs, CrCL-24hrs, eGFRCr-CysC-24hrs, eGFRCr-72hrs, eGFRCr-CysC-72hrs equations were ? 0.05, which helps diagnose AKI. Logistic regression was >0.05 for in- hospital-mortality prediction, addressing none of the equations led to death prediction. Conclusions: eGFRCr-24hrs had the highest correlation to measured CrCL-24hrs, with correlation coefficient of 0.81 (p<0.001). The most accurate equation was eGFRCr-72hrs However, eGFRCysC-24hrs equation had the lowest bias and was relatively more precise (60.0?ml/min). Using logistic regression, most of the equations contributed to diagnosing AKI. However, none of the equation predicted in-hospital-mortality.

Item Type:	Conference or Workshop Item (Poster)
Uncontrolled Keywords:	Glomerular Filtration Rate
Subjects:	R Medicine > R Medicine (General)
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care Kulliyyah of Medicine > Department of Radiology
Depositing User:	Prof Azrina Md Ralib
Date Deposited:	24 Sep 2021 10:06
Last Modified:	24 Sep 2021 10:06
URI:	http://irep.iium.edu.my/id/eprint/92394

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