Recommendations to evaluate the glomerular filtration rate below 60 ml/min/1.73 m2 in patients with kidney disease and diabetes

Authors

  • Florencia Aranguren University of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Yanina Castaño Nephrological Center of Olavarría, Province of Buenos Aires, Argentina
  • Guillermo De'Marziani Center for Kidney Diseases and Arterial Hypertension (CEREHA), Province of Buenos Aires, Argentina
  • Alicia Elbert Hospital de Clínicas José de San Martín, Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v56i2Sup.540

Keywords:

renal function, glomerular filtration rate, creatinine, creatinine clearance

Abstract

To diagnose,classify and stage diabetic kidney disease in patients with diabetes mellitus is a challenge in clinical practice for both primary care physicians and specialists because there is no method in clinical practice that evaluates accurately the glomerular filtration rate (GFR).
This challenge is due to difficulties in evaluating kidney function in stages of chronic kidney disease (CKD) below 60 ml/min/1.73m2 corresponding to stages 3, 4 and 5 of the classification, because the available tools in clinical laboratories are of limited accuracy.
This work explores the conditions that an ideal marker should meet, the difficulties offered by the evaluation of serum creatinine, the measurement of the glomerular filtration rate (GFR) as well as the advantages and limitations of the recommendations of the use of formulas for its determination and the current algorithm to estimate renal function.
Conclusions: currently, despite the limitations, the use of formulas for the diagnosis of renal function is recommended, especially in GFR below 60 ml/min/1.73 m2. It is a challenge for the near future to develop better tools for the evaluation of TGF.

Author Biographies

Florencia Aranguren, University of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Physician specialized in Diabetes, Argentine Diabetes Society (SAD), specialist in Internal Medicine, University of Buenos Aires (UBA), Director of the Diploma in Cardiometabolic and Renal Risk, University of Business and Social Sciences (UCES)

Yanina Castaño, Nephrological Center of Olavarría, Province of Buenos Aires, Argentina

Medical specialist in Nutrition, University of Buenos Aires (UBA), Master in Diabetes, University of Salvador (USAL); Coordinator of the Nephropathy Committee of the Argentine Diabetes Society (SAD); Coordinator of the Diabetes Area of ??the Olavarría Nephrological Center

Guillermo De'Marziani, Center for Kidney Diseases and Arterial Hypertension (CEREHA), Province of Buenos Aires, Argentina

Doctor specializing in Internal Medicine, specialist in Nephrology and Internal Environment Master in Diabetes; Staff doctor at the Center for Kidney Diseases and Arterial Hypertension

Alicia Elbert, Hospital de Clínicas José de San Martín, Autonomous City of Buenos Aires, Argentina

Nephrologist, University of Buenos Aires (UBA), specialized in Diabetes; Pedagogical Psychodramatist; Former assigned researcher, Diabetes Service of the José de San Martín Hospital de Clínicas; Director of the Center for Kidney Diseases and Arterial Hypertension (CEREHA)

References

I. Commendatore V, Curcio D, Proietti A, Facio ML, González A, De Marziani G, et al. Herramientas para el diagnóstico y seguimiento de la enfermedad renal diabética. En: Albert A. Diabetes mellitus y riñón: Enfoque transdisciplinario. 1º Ed. Ciudad Autónoma de Buenos Aires: Journal 2022;43-65

II. Levey AS, Coresh J, Tighiouart H, Greene T, Inker LA. Measured and estimated glomerular filtration rate: current status and future directions. Nat Rev Nephrol 2020;16(1):51-64.

III. Kidney disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2013;3:1-150.

IV. American Diabetes Association Professional Practice Committee. Erratum. 11. Chronic kidney disease and risk management: standards of medical care in diabetes-2022. Diabetes Care 2022;45(Suppl. 1):S175-S184.

V. Martínez YV, Benett I, Lewington AJP, Wierzbicki AS; Guideline Committee. Chronic kidney disease: summary of updated NICE guidance. BMJ 20216;374: n1992.

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Published

2022-08-01

How to Cite

Aranguren, F., Castaño, Y., De’Marziani, G., & Elbert, A. (2022). Recommendations to evaluate the glomerular filtration rate below 60 ml/min/1.73 m2 in patients with kidney disease and diabetes. Journal of the Argentine Society of Diabetes, 56(2Sup), 60–62. https://doi.org/10.47196/diab.v56i2Sup.540

Issue

Vol. 56 No. 2Sup (2022): May/Agost 2022

Section

Recommendations

License

Copyright (c) 2022 on behalf of the authors. Reproduction rights: Argentine Diabetes Society

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.

La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.

Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.

 

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