Correlation of glomerular filtrate with CKD-EPI ecuation in patients with renal hyperfiltration

Abstract

The estimation of glomerular filtration is a variable of extensive clinical use and has a transcendental importance regarding a broad decision making. Among them, the adjustment of the drug dose must be adapted to modifications of the glomerular filtration value, since doses outside the therapeutic range result in plasma concentrations that move away from the treatment objective. Decreased glomerular filtration may result in supra-optimal doses of a given drug causing increased likelihood of serious, even potentially fatal, adverse effects. It is for this reason that the decrease in antibiotic dose is made according to the value of glomerular filtration obtained by predictive formulas such as Cockroft and Gault. However, to date, there is no academic source that proposes increasing the dose of antibiotics in the face of increased glomerular filtration. Predictive formulations include a wide variety and all have been tested in the clinic with the exception of the CKD-EPI formula. None of the mentioned formulas has a good correlation with high values of glomerular filtration except the CKD-EPI that has not been studied in this aspect. The analysis of the validity of the CKD¬EPI formula in patients with increased glomerular filtration rate (hyperfiltrating kidney) may provide a very important data that could contribute to modify the treatment and promote its optimization. The results in the analyzed population sample constituted by 31 patients and after the statistical analysis no correlation was found between the values of creatinine clearance of hyper filtered kidneys from 24 hours urine with the correlative values estimated by the CKD-EPI and MDRD formulas