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10.1136/bmjopen-2015-007835 http://scihub22266oqcxt.onion/10.1136/bmjopen-2015-007835 C4593164!4593164 !26399570     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=26399570 &cmd=llinks): Failed to open stream: HTTP request failed! 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Glomerular filtration rate (GFR) during and after STEMI: a single-centre, methodological study comparing estimated and measured GFR |pdf=|usr=}}{{26399570 }} gab.com Text Glomerular filtration rate (GFR) during and after STEMI: a single-centre, methodological study comparing estimated and measured GFR JO: BMJ Open http://www.kidney.de/pget.php?&tw=1&pmid=26399570 #FOAvip OBJECTIVES: To validate the performance of the most commonly used formulas for estimation of glomerular filtration rate (GFR) against measured GFR during the index hospitalisation for ST-elevation myocardial infarction (STEMI). SETTING: Single centre, methodological study. PARTICIPANTS: 40 patients with percutaneous coronary intervention-treated STEMI were included between November 2011 and February 2013. Patients on dialysis, cardiogenic shock or known allergy to iodine were excluded. OUTCOME MEASURES: Creatinine and cystatin C were determined at admission and before discharge in 40 patients with STEMI. Clearance of iohexol was measured (mGFR) before discharge. We evaluated and compared the Cockcroft-Gault (CG), the Modification of Diet in Renal Disease (MDRD-IDMS), the Chronic Kidney Disease Epidemiology (CKD-EPI) and the Grubb relative cystatin C (rG-CystC) with GFR regarding correlation, bias, precision and accuracy (P30). Agreement between eGFR and mGFR to discriminate CKD was assessed by Cohen's ? statistics. RESULTS: MDRD-IDMS and CKD-EPI demonstrated good performance to estimate GFR (correlation 0.78 vs 0.81%, bias -1.3% vs 1.5%, precision 17.9 vs 17.1?mL/min 1.73?m(2) and P30 82.5% vs 82.5% for MDRD-IDMS vs CKD-EPI). CKD was best classified by CKD-EPI (? 0.83). CG showed the worst performance (correlation 0.73%, bias -1% to 3%, precision 22.5?mL/min 1.73?m(2) and P30 75%). The rG-CystC formula had a marked bias of -17.8% and significantly underestimated mGFR (p=0.03). At arrival, CKD-EPI and rG-CystC had almost perfect agreement in CKD classification (?=0.87), whereas at discharge agreement was substantially lower (?=0.59) and showed a significant discrepancy in CKD classification (p=0.02). Median cystatin C concentration increased by 19%. CONCLUSIONS: In acute STEMI, CKD-EPI showed the best CKD-classification ability followed by MDRD-IDMS, whereas CG performed the worst. STEMI altered the performance of the cystatin C equation during the acute phase, suggesting that other factors might be involved in the rise of cystatin C. Twit Text FOAVip Glomerular filtration rate (GFR) during and after STEMI: a single-centre, methodological study comparing estimated and measured GFR ????BMJ Open http://www.kidney.de/pget.php?&tw=1&pmid=26399570 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=26399570 #FOAvip English Wikipedia <ref>{{Cite pmid|26399570 }}</ref> Glomerular filtration rate (GFR) during and after STEMI: a single-centre, methodological study comparing estimated and measured GFR #MMPMID26399570 Venetsanos D ; Alfredsson J ; Segelmark M ; Swahn E ; Lawesson SS BMJ Open 2015[Sep]; 5 (9 ): e007835 PMID26399570 show ga OBJECTIVES: To validate the performance of the most commonly used formulas for estimation of glomerular filtration rate (GFR) against measured GFR during the index hospitalisation for ST-elevation myocardial infarction (STEMI). SETTING: Single centre, methodological study. PARTICIPANTS: 40 patients with percutaneous coronary intervention-treated STEMI were included between November 2011 and February 2013. Patients on dialysis, cardiogenic shock or known allergy to iodine were excluded. OUTCOME MEASURES: Creatinine and cystatin C were determined at admission and before discharge in 40 patients with STEMI. Clearance of iohexol was measured (mGFR) before discharge. We evaluated and compared the Cockcroft-Gault (CG), the Modification of Diet in Renal Disease (MDRD-IDMS), the Chronic Kidney Disease Epidemiology (CKD-EPI) and the Grubb relative cystatin C (rG-CystC) with GFR regarding correlation, bias, precision and accuracy (P30). Agreement between eGFR and mGFR to discriminate CKD was assessed by Cohen's ? statistics. RESULTS: MDRD-IDMS and CKD-EPI demonstrated good performance to estimate GFR (correlation 0.78 vs 0.81%, bias -1.3% vs 1.5%, precision 17.9 vs 17.1?mL/min 1.73?m(2) and P30 82.5% vs 82.5% for MDRD-IDMS vs CKD-EPI). CKD was best classified by CKD-EPI (? 0.83). CG showed the worst performance (correlation 0.73%, bias -1% to 3%, precision 22.5?mL/min 1.73?m(2) and P30 75%). The rG-CystC formula had a marked bias of -17.8% and significantly underestimated mGFR (p=0.03). At arrival, CKD-EPI and rG-CystC had almost perfect agreement in CKD classification (?=0.87), whereas at discharge agreement was substantially lower (?=0.59) and showed a significant discrepancy in CKD classification (p=0.02). Median cystatin C concentration increased by 19%. CONCLUSIONS: In acute STEMI, CKD-EPI showed the best CKD-classification ability followed by MDRD-IDMS, whereas CG performed the worst. STEMI altered the performance of the cystatin C equation during the acute phase, suggesting that other factors might be involved in the rise of cystatin C. |*Electrocardiography [MESH] |Aged [MESH] |Creatinine/*blood [MESH] |Cystatin C/*blood [MESH] |Female [MESH] |Glomerular Filtration Rate/*physiology [MESH] |Humans [MESH] |Intraoperative Period [MESH] |Male [MESH] |Myocardial Infarction/complications/*physiopathology/surgery [MESH] |Percutaneous Coronary Intervention/*methods [MESH] |Postoperative Period [MESH] |Prevalence [MESH] |ROC Curve [MESH] |Renal Insufficiency, Chronic/*epidemiology/etiology/physiopathology [MESH]Glomerular filtration rate (GFR) during and after STEMI: a single-cent(epmc).pdf DeepDyve Pubget Overpricing