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Rev Assoc Med Bras (1992) · Jan 2024
Different methods for assessing glomerular filtration rate in the elderly.
- Gilsirene Scantelbury de Almeida, Noeli das Neves Toledo, Miharu Maguinoria Matsuura Matos, Luis Cuadrado Martin, and Roberto Jorge da Silva Franco.
- Universidade Federal do Amazonas, Manaus School of Nursing - Manaus (AM), Brazil.
- Rev Assoc Med Bras (1992). 2024 Jan 1; 70 (1): e20221101e20221101.
ObjectiveThe objective of this study was to identify the best method to replace cystatin C in the evaluation of glomerular filtration in the elderly.MethodsIndividuals over 60 years of age from a primary care center were studied. Blood was collected to determine creatinine and cystatin C and 24-h urine. Three methods were compared to determine glomerular filtration: Creatinine clearance, Cocroft-Gault, modification of diet in renal disease, and Collaboration Epidemiology of Chronic Kidney Disease based on creatinine, considering as a reference the determination of glomerular filtration using the cystatin-based Chronic Kidney Disease Epidemiology Collaboration equation. The statistical methods used were linear regression, Bland-Altman curve, and receiver operating characteristic.ResultsA total of 180 elderly people were evaluated, but 14 patients were lost from the sample, resulting in a total of 166 patients. The average age of patients was 66.9±6.1 years, and 69.8% were females. Regarding the number of patients eligible for the study, there were 12 black, 108 brown, and 46 white, 42.77% hypertensive, and 38.3% diabetic. Glomerular filtration was less than 60 mL/min in 22.28% of patients. Regarding the evaluation of the different equations, the correlation coefficient was lower for creatinine clearance and progressively higher for Cocroft-Gault, modification of diet in renal disease, and Collaboration Epidemiology of Chronic Kidney Disease based on creatinine. The Bland-Altman diagram and the receiver operating characteristic curve showed similar performance to the correlation coefficient for the different equations evaluated.ConclusionCollaboration Epidemiology of Chronic Kidney Disease based on creatinine presented the best performance. Creatinine debug had the worst performance, which reinforces the idea that 24-h urine collection is unnecessary in these patients.
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