TITLE:
Two-Hour Creatinine Clearance and Glomerular Filtration Rate Estimated from Serum Cystatin C and Creatinine in the Elderly to Preoperative Period
AUTHORS:
Leopoldo Muniz da Silva, Pedro Thadeu Galvão Vianna, Mariana Takaku, Glênio Bittencourt Mizubuti, Yara Marcondes Machado Castiglia
KEYWORDS:
Renal Function; Creatinine Clearance; Cystatin C; Elderly
JOURNAL NAME:
Open Journal of Nephrology,
Vol.3 No.4,
December
13,
2013
ABSTRACT:
Introduction: The utility of estimates of glomerular filtration rate based on
creatinine and cystatin C serum levels to assess renal function in older
surgical patients remains to be determined. Objective: To determine whether 2h-creatinine clearance
(CrCl-2h) can be an adequate substitute for glomerular filtration rate
estimates obtained by measuring serum cystatin C and creatinine in the elderly
at preoperation. Methods: A total of
102 consecutive elder patients undergoing pre-anesthesia evaluation for routine
surgeries were included. Study subjects were allocated into three groups: Group
1 (G1)—hypertensive diabetic patients, Group 2 (G2)—hypertensive patients, and
Group 3 (G3)—non-hypertensive and non-diabetic patients. Two-hour urine
collection was performed and CrCl-2h adjusted for ultrasonic residual bladder
volume was estimated. GFR was estimated based on creatinine and cystatin C
serum levels. Bland-Altman analysis was used to compare methods. Results: The mean difference between
the evaluated methods and CrCl-2h was ·min-1·1.73 m-2 for Cys-GFR, and >20 mL·min-1·1.73 m-2 for Cr-GFR in
all groups. CrCl-2h adjusted for ultrasonic
residual bladder volume did not differ from non-adjusted CrCl-2h in none of the
groups. Conclusion: Two-hour creatinine clearance was not an adequate substitute for GFR estimates
based on creatinine and cystatin C serum levels in older patients at
preoperation. The ultrasonic assessment of residual bladder volume had no
significant influence on the calculation of two-hour creatinine clearance.