Kolwelter J, Striepe K, Bosch A, Kannenkeril D, Ott C, Schiffer M, Schmieder R (2022)
Publication Type: Journal article
Publication year: 2022
Book Volume: 14
Journal Issue: 1
DOI: 10.1186/s13098-022-00874-1
Background After initiating cardioprotective agents, a fall of estimated glomerular filtration rate (eGFR) has been reported in several studies. Our goal was to evaluate the accuracy of change of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR in patients with type 2 diabetes (T2D) after short-term pharmacological intervention with angiotensin-converting enzyme inhibitor, angiotensin-receptor blocker, gliptin or sodium-glucose cotransporter-2 inhibitor. Methods We analyzed 190 patients with T2D in the early stage of the disease, having no overt renal impairment by CKD-EPI equation. In each patient, we measured GFR (mGFR) by applying the constant infusion input clearance technique with sinistrin (Inutest; Fresenius, Linz, Austria) at baseline and after short-term (4-12 weeks) pharmacological intervention with cardioprotective agents (ramipril, telmisartan, linagliptin, metformin, empagliflozin) that potentially lead to an alteration of renal function. Simultaneously, a standardized analysis of serum creatinine was performed and eGFR was estimated by the CKD-EPI equation. Results Average mGFR was 111 +/- 20 ml/min/1.73m(2), whereas eGFR was lower with 93 +/- 13 ml/min/1.73m(2). The ratio eGFR/mGFR in relation to mGFR was almost curvilinear, showing an underestimation of renal function by eGFR in the upper normal range. At baseline only 80 patients (42%) lay within +/- 10% of mGFR and the concordance correlation coefficient (CCC) was extremely low (- 0.07). After short-term pharmacological intervention changes in eGFR and mGFR correlated with each other (r = 0.286, p < 0.001). For example, for a given mGFR of 111 ml/min/1.73m(2), a change of mGFR by +/- 10% corresponded to +/- 11 ml/min/1.73m(2), but the confidence interval of eGFR was 25 ml/min/1.73m(2). The CCC was low (0.22). Conclusion The agreement between eGFR by CKD-EPI and mGFR is modest and the change of renal function after short-term pharmacological intervention is not accurately and precisely reflected by the change of eGFR in patients with T2D in the early stage of their disease.
APA:
Kolwelter, J., Striepe, K., Bosch, A., Kannenkeril, D., Ott, C., Schiffer, M., & Schmieder, R. (2022). Change of renal function after short-term use of cardioprotective agents in patients with type 2 diabetes is not accurately assessed by the change of estimated glomerular filtration rate: an observational study. Diabetology & Metabolic Syndrome , 14(1). https://doi.org/10.1186/s13098-022-00874-1
MLA:
Kolwelter, Julie, et al. "Change of renal function after short-term use of cardioprotective agents in patients with type 2 diabetes is not accurately assessed by the change of estimated glomerular filtration rate: an observational study." Diabetology & Metabolic Syndrome 14.1 (2022).
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