• Clin. Chim. Acta · Dec 2016

    Estimated glomerular filtration rate calculated using different creatinine and cystatin based formulas in prediction of trough plasma Dabigtran concentration.

    • Gianluca Gessoni, Sara Valverde, Francesca Gessoni, Letizia Valle, and Roberto Valle.
    • Transfusional Dept., Ospedale dell'Angelo, Mestre, Italy. Electronic address: gianluca.gessoni@ulss12.ve.it.
    • Clin. Chim. Acta. 2016 Dec 1; 463: 22-26.

    BackgroundIn this paper we evaluated the relationship between trough DAB concentration with eGFR calculated using CRE and CYS based formulas.Materials And MethodsWe considered 100 patients. eGFR was calculated using CKD-EPIcreat, CG, MDRD, CKD-EPIcys and CKD-EPIcombined equations. DAB dosage was selected on the basis of CKD-EPIcreat and relationship between trough DAB concentration and eGFRs was evaluated.ResultsTrough DAB concentration roughly correlates with eGFR calculated using various formulas. CKD-EPIcreat eGFR was higher than CKD-EPIcys. In patients receiving a DAB dosage considered adequate using CKD-EPIcreat eGFR but considered excessive using CKD-EPIcys, we observed higher DAB trough concentration and an increased prevalence of subjects with drug concentration >200ng/mL.ConclusionThese results suggest that eGFR alone was unable to fully explain trough DAB plasma concentration. Therefore a drug's prescription schedule based on eGFR only should be inadequate. We observed a better correlation between trough DAB concentration and CKD-EPIcys rather than CKD-EPIcreat eGFR. Thus, in patients chronically treated with DAB for thromboprophylaxis in nonvalvular atrial fibrillation evaluation of eGFR using a cystatin base formula should be considered.Copyright © 2016 Elsevier B.V. All rights reserved.

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