Prognostic relevance of glomerular filtration rate estimation obtained through different equations in hospitalized elderly patients

被引：5

作者：

Gallo, Paolo ^{[1
,28
]}

De Vincentis, Antonio ^{[1
]}

Pedone, Claudio ^{[1
]}

Nobili, Alessandro ^{[2
]}

Tettamanti, Mauro ^{[2
]}

Gentilucci, Umberto Vespasiani ^{[1
,28
]}

Picardi, Antonio ^{[1
,28
]}

Mannucci, Pier Mannuccio ^{[3
]}

Incalzi, Raffaele Antonelli ^{[1
]}

Prisco, Domenico ^{[4
]}

Silvestri, Elena ^{[4
]}

Emmi, Giacomo ^{[4
]}

Bettiol, Alessandra ^{[4
]}

Caterina, Cenci ^{[4
]}

Biolo, Gianni ^{[5
]}

Zanetti, Michela ^{[5
]}

Guadagni, Martina ^{[5
]}

Zaccari, Michele ^{[1
,5
]}

Chiuch, Massimiliano ^{[5
]}

Zaccari, Michele ^{[1
,5
]}

Vanoli, Massimo ^{[6
]}

Grignani, Giulia ^{[6
]}

Pulixi, Edoardo Alessandro ^{[6
]}

Bernardi, Mauro ^{[7
]}

Bassi, Silvia Li ^{[7
]}

Santi, Luca ^{[7
]}

Zaccherini, Giacomo ^{[7
]}

Lupattelli, Graziana ^{[8
]}

Mannarino, Elmo ^{[8
]}

Bianconi, Vanessa ^{[8
]}

Paciullo, Francesco ^{[8
]}

Alcidi, Riccardo ^{[8
]}

Nuti, Ranuccio ^{[9
]}

Valenti, Roberto ^{[9
]}

Ruvio, Martina ^{[9
]}

Cappelli, Silvia ^{[9
]}

Palazzuoli, Alberto ^{[9
]}

Girelli, Domenico ^{[10
]}

Busti, Fabiana ^{[10
]}

Marchi, Giacomo ^{[10
]}

Barbagallo, Mario ^{[11
]}

Dominguez, Ligia ^{[11
]}

Cocita, Floriana ^{[11
]}

Beneduce, Vincenza ^{[11
]}

Plances, Lidia ^{[11
]}

Corrao, Salvatore ^{[12
]}

Natoli, Giuseppe ^{[12
]}

Mularo, Salvatore ^{[12
]}

Raspanti, Massimo ^{[12
]}

Cavallaro, Federica ^{[12
]}

机构：

[1] Univ Campus Biomed, Dept Med, Rome, Italy

[2] IRCCS Ist Ric Farmacol Mario Negri, Milan, Italy

[3] Univ Milan, IRCCS Ca Granda Maggiore Hosp Fdn, Bianchi Bonomi Hemophilia & Thrombosis Ctr, Milan, Italy

[4] Azienda Osped Univ Careggi Firenze, Med Interna Interdisciplinare, Florence, Italy

[5] Azienda Sanitaria Univ Integrata Trieste, Clin Med Gen & Terapia Med, Trieste, Italy

[6] Osped Merate, Azienda Osped Prov Lecco, Med Interna, Lecce, Italy

[7] Azienda Osped Policlin St Orsola Malpighi, Semeiot Med Bernardi, Bologna, Italy

[8] Azienda Osped Santa Maria Misericordia, Med Interna, Perugia, Italy

[9] Azienda Osped Univ Senese, Med Interna 1, Siena, Italy

[10] Azienda Osped Univ Integrata Verona, Med Gen & Malattie Aterotrombot Degenerat, Verona, Italy

[11] Azienda Osped Univ, Policlin Giaccone, Policlin Palermo, Unita Operat Geriatria & Lungodegenza, Palermo, Italy

[12] UOC Med Interna Indirizzo Geriatr Riabilitat, ARNAS Civ, Palermo, Italy

[13] Azienda Osped Univ, Policlin S Orsola Malpighi, Unita Operat Med Interna, Bologna, Italy

[14] Azienda Osped Univ Senese, Unita Operat Complessa Med 2, Siena, Italy

[15] Azienda Osped Univ Consorziale, Policlin Bari, Med Interna Osped L DAgostino, Med Interna Univ A Murri, Bari, Italy

[16] Osped Maggiore Policlin, Unita Operat Med Interna IA, Fdn IRCCS Ca Granda, Milan, Italy

[17] Osped Maggiore Policlin, Geriatria, Fdn IRCCS Ca Granda, Milan, Italy

[18] IRCCS Policlin San Matteo Pavia, Clin Med 1, Reparto 11, Pavia, Italy

[19] IRCCS Azienda Osped Univ San Martino IST Genova, Clin Med Interna 2, Genoa, Italy

[20] Osped Bassini Cinisello Balsamo, Div Med, Milan, Italy

[21] Osped Civile Jazzolino Vibo Valentia, Med Interna, Vibo Valentia, Italy

[22] Osped Clinicizzato SS, Clin Med, Chieti, Italy

[23] Osped Giovanni Paolo II Lamezia Terme, Unita Operat Complessa Med Interna, Catanzaro, Italy

[24] Azienda Osped Univ Sassari, Clin Med, Sassari, Italy

[25] Sapienza Univ Roma, Policlin Umberto I, Med Interna & Nutr Clin Policlin Umberto I, Rome, Italy

[26] Policlin Univ A Gemelli, Unita Operat Complessa Med Urgenza & Pronto Socco, Rome, Italy

[27] Spedali Civili Brescia, Geriatr, Brescia, Italy

[28] Univ Campus Biomed, Med Clin Epatol, Rome, Italy

[29] Univ Milano Bicocca, Osped S Gerardo, Unita Operat Geriatria, Monza, Italy

[30] Univ Magna Grecia, Policlin Mater Domini, Unita Operat Complessa Med Interna, Catanzaro, Italy

[31] Azienda Osped Cardinale Panico Tricase, Unita Operat Complessa Med, Lecce, Italy

[32] Azienda Osped Osped San Camillo Forlanini, Med Interna 1, Rome, Italy

[33] Azienda Osped Papa Giovanni XXIII, Med 1, Bergamo, Italy

[34] Azienda Osped Univ Padova, Clin Med 1, Padua, Italy

[35] Azienda Osped Univ St Anna, Unita Operat Clin Med, Ferrara, Italy

[36] Seconda Univ Studi Napoli, Azienda Osped Univ, Div Med Interna & Malattie Nutr Invecchiamento 4, Naples, Italy

[37] Azienda Osped Univ Consorziale, Policlin Bari, Med Interna Univ C Frugoni, Bari, Italy

[38] Azienda Sanit Osped Santa Croce & Carle Cunco, SC Med Interna, Cuneo, Italy

[39] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Med Interna 1B, Milan, Italy

[40] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, UOC Med Gen Emostatsi & Trombosi, Milan, Italy

[41] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Med Interna Alta Intens, Milan, Italy

[42] IRCCS Policlin San Donato, Milan, Italy

[43] Univ Milan, Med Interna, Milan, Italy

[44] Univ Genoa, Med Interna 1, Genoa, Italy

[45] Osped Casorate Primo, ASST Pavia, UOSD Med Interna, Pavia, Italy

[46] Azienda Osped Bolognini Seriate, Osped SS Gerosa& Capitanio Lovere, Unita Operat Complessa Med Gen, Bergamo, Italy

[47] Osped Garibaldi Nesima, Unita Operat Complessa Med Interna, Catania, Italy

[48] Osped Poliambulanza, Med Interna & Geriatira, Brescia, Italy

[49] Univ Torino, Dipartimento Sci Med, Citta Sci & Salute, Med Interna U Indirizzo Urgenza 2, Turin, Italy

[50] Azienda Osped Univ S Anna, Unita Operat Med Osped 2, Ferrara, Italy

来源：

EUROPEAN JOURNAL OF INTERNAL MEDICINE | 2018年 / 54卷

关键词：

Glomerular filtration rate estimation; eGFR; Elderly in-patients; Prognosis; CHRONIC KIDNEY-DISEASE; ALL-CAUSE; CREATININE CLEARANCE; RENAL-INSUFFICIENCY; SERUM CREATININE; MORTALITY RISK; PREDICTION; ASSOCIATION; PREVALENCE; ALBUMINURIA;

D O I：

10.1016/j.ejim.2018.04.001

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The estimated glomerular filtration rate (eGFR) is a predictor of important outcomes and its reduction has been associated with the risk of all-cause mortality in both general population and elderly patients. However while reduced renal function is common in older people, the best method for estimating GFR remains unclear, especially in an acute care setting. Most studies analyzing the accuracy of eGFR in the elderly were carried out in different heterogeneous settings. In this study, we compare the prognostic value of different formulas estimating GFR in predicting the risk of in-hospital morbidity and mortality within 3 months from discharge in elderly hospitalized patients. Data were extracted from "Registro Politerapia Societh. Italian di Medicina Interna (REPOSI)". Patients with available creatinine values at hospital admission were selected and eGFR was calculated according to the different formulas: Cockcroft-Gault, Modification of Diet in Renal Disease equation, Chronic Kidney Disease Epidemiology Collaboration, Berlin Initiative Study and Full Age Spectrum. 4621 patients were included in the analysis. Among these, 4.2% and 14.2% died during hospitalization and within 3 months from discharge, respectively. eGFR > 60 ml/min/1.73 m(2) at admission was associated with a very low risk of mortality during the hospital stay and within 90 days from discharge, while an eGFR < 60 ml/min/1.73 m(2) was associated with unfavorable outcomes, although with a poor level of accuracy (AUC 0.60-0.66). No difference in predictive power between different equations was found. Physicians should be aware of the prognostic role of eGFR in a comprehensive assessment of elderly in-patients.

引用

页码：60 / 64

页数：5

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