05 May Performance of Formulas for Estimating Kidney Function in the Elderly

MedicalResearch.com Interview with:
Dr. Luciano da Silva Selistre MD MS PhD
Professor de Medicina – UCS

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:   We have found that no equation for estimating renal function in the elderly is fully accurate. There are important mistakes between them.

MedicalResearch.com: What should readers take away from your report?

Response:     We recommend that clinicians (according KDIGO)

1. Use a GFR estimating equation to derive GFR from serum creatinine rather than relying on the serum creatinine concentration alone.
2. Understand clinical settings in which eGFRcreat is less accurate.
3. Recognize commonly used drugs that require dose adjustment or use with caution in elderly  

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response:        We suggest (according KDIGO)

1.        Use a GFR estimating equation to derive GFR from serum creatinine rather than relying on the serum creatinine concentration alone.
2.        We recommend eGFRcreat levels less than 45 ml/min/1.73 m2 should be reported as ‘‘decreased.’’ to elderly.
3.        Measuring GFR using an exogenous filtration marker under circumstances where more accurate ascertainment of GFR will impact on treatment   decisions. (eg. transplantation)

MedicalResearch.com: Is there anything else you would like to add?

Response: We would like to be able to test mixed equations with creatinine and cystatin C for this group of patients. However, due to economic reasons, there was no possibility for this laboratory technique.

Currently, a new line of research that we are undertaking is the development of machine learning for this group of elderly patients to idendify a pattern of renal function evaluation through baysian analysis.

We would like to participate with other North American groups, such as the CKD-EPI group, to assess the outcomes of patients with mesured GFR <45 mL /   min / 1.73 m2 

Citation:

Song Z, Baicker K. Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes: A Randomized Clinical Trial. JAMA. 2019;321(15):1491–1501. doi:10.1001/jama.2019.3307

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Last Updated on May 5, 2019 by Marie Benz MD FAAD