Obesity, Hyperfiltration, and Early Kidney Damage: A New Formula for the Estimation of Creatinine Clearance
Abstract Context Glomerular hyperfiltration may represent a direct pathogenetic link between obesity and kidney disease. The most widely used methods to estimate creatine clearance such as Cockroft–Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Coll...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2023-12, Vol.108 (12), p.3280-3286 |
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| container_title | The journal of clinical endocrinology and metabolism |
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| creator | Basolo, Alessio Salvetti, Guido Giannese, Domenico Genzano, Susanna Bechi Ceccarini, Giovanni Giannini, Riccardo Sotgia, Gianluca Fierabracci, Paola Piaggi, Paolo Santini, Ferruccio |
| description | Abstract
Context
Glomerular hyperfiltration may represent a direct pathogenetic link between obesity and kidney disease. The most widely used methods to estimate creatine clearance such as Cockroft–Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) have not been validated in subjects with obesity.
Objective
The performance of prediction formulas was compared with measured creatinine clearance (mCrCl) in subjects with obesity.
Methods
The study population included 342 patients with obesity (mean BMI 47.6 kg/m2) without primary kidney disease. A urine collection was performed over 24 hours for measurement of CrCl.
Results
mCrCl increased with body weight. The CG formula showed an overestimation at high CrCl, whereas an underestimation resulted from CKD-EPI and MDRD. To improve the accuracy of estimated CrCl (eCrCl), a new CG-based formula was developed:53+0.7×(140−Age)×Weight/(96xSCr)×(0.85iffemale)A cut-off point for BMI of 32 kg/m2 was identified, at which the new formula may be applied to improve eCrCl.
Conclusion
In patients with obesity the glomerular filtration rate increases with body weight, and it is associated with the presence of albuminuria, suggesting an early kidney injury. We propose a novel formula that improves the accuracy of eCrCl to avoid missed diagnoses of hyperfiltration in patients with obesity. |
| doi_str_mv | 10.1210/clinem/dgad330 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2824687404</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A775958580</galeid><oup_id>10.1210/clinem/dgad330</oup_id><sourcerecordid>A775958580</sourcerecordid><originalsourceid>FETCH-LOGICAL-c464t-e552bcf7c3bc78803ed19832bb1f232446852d4df0d7c9be888d9fc64da900b93</originalsourceid><addsrcrecordid>eNqFkc9rFDEcxYModrt69SgBLwqdNj83ibdl3Vqx2IuCt5BJvrNOnZmsyQwy_31Td1WQguTwzeHzHo_3EHpByTlllFz4rh2gvwg7Fzgnj9CCGiErRY16jBaEMFoZxb6eoNOcbwmhQkj-FJ1wxcxKcr5A329qyO04n-GreQ-pabsxubGNwxl2Q8Bbl7oZf2zDADN-53q3g7d4jT_BT3wZUz91Djcx4fEb4G0e2_6XFMcGbxKU_1DC4U0HLrnBwzP0pHFdhufHu0RfLrefN1fV9c37D5v1deXFSowVSMlq3yjPa6-0JhwCNZqzuqYN40yIlZYsiNCQoLypQWsdTONXIjhDSG34Er0--O5T_DFBHm3fZg9d5waIU7ZMs-KhBBEFffUPehunNJR0lhkpOaGK67_UznVg26GJpSR_b2rXSkkjtSwxl-j8Aaq8AH3r4wClXHhQ4FPMOUFj96lUmGZLib1f1x7Wtcd1i-DlMe1U9xD-4L_nLMCbAxCn_f_M7gBScK5F</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2955301738</pqid></control><display><type>article</type><title>Obesity, Hyperfiltration, and Early Kidney Damage: A New Formula for the Estimation of Creatinine Clearance</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Basolo, Alessio ; Salvetti, Guido ; Giannese, Domenico ; Genzano, Susanna Bechi ; Ceccarini, Giovanni ; Giannini, Riccardo ; Sotgia, Gianluca ; Fierabracci, Paola ; Piaggi, Paolo ; Santini, Ferruccio</creator><creatorcontrib>Basolo, Alessio ; Salvetti, Guido ; Giannese, Domenico ; Genzano, Susanna Bechi ; Ceccarini, Giovanni ; Giannini, Riccardo ; Sotgia, Gianluca ; Fierabracci, Paola ; Piaggi, Paolo ; Santini, Ferruccio</creatorcontrib><description>Abstract
Context
Glomerular hyperfiltration may represent a direct pathogenetic link between obesity and kidney disease. The most widely used methods to estimate creatine clearance such as Cockroft–Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) have not been validated in subjects with obesity.
Objective
The performance of prediction formulas was compared with measured creatinine clearance (mCrCl) in subjects with obesity.
Methods
The study population included 342 patients with obesity (mean BMI 47.6 kg/m2) without primary kidney disease. A urine collection was performed over 24 hours for measurement of CrCl.
Results
mCrCl increased with body weight. The CG formula showed an overestimation at high CrCl, whereas an underestimation resulted from CKD-EPI and MDRD. To improve the accuracy of estimated CrCl (eCrCl), a new CG-based formula was developed:53+0.7×(140−Age)×Weight/(96xSCr)×(0.85iffemale)A cut-off point for BMI of 32 kg/m2 was identified, at which the new formula may be applied to improve eCrCl.
Conclusion
In patients with obesity the glomerular filtration rate increases with body weight, and it is associated with the presence of albuminuria, suggesting an early kidney injury. We propose a novel formula that improves the accuracy of eCrCl to avoid missed diagnoses of hyperfiltration in patients with obesity.</description><identifier>ISSN: 0021-972X</identifier><identifier>ISSN: 1945-7197</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/clinem/dgad330</identifier><identifier>PMID: 37296533</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Body weight ; Chronic kidney failure ; Comparative analysis ; Creatine ; Creatinine ; Development and progression ; Epidemiology ; Glomerular Filtration Rate ; Humans ; Kidney ; Kidney diseases ; Kidney Function Tests ; Medical research ; Medicine, Experimental ; Obesity ; Obesity - complications ; Population studies ; Renal Insufficiency, Chronic - diagnosis ; Type 2 diabetes</subject><ispartof>The journal of clinical endocrinology and metabolism, 2023-12, Vol.108 (12), p.3280-3286</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.</rights><rights>COPYRIGHT 2023 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-e552bcf7c3bc78803ed19832bb1f232446852d4df0d7c9be888d9fc64da900b93</citedby><cites>FETCH-LOGICAL-c464t-e552bcf7c3bc78803ed19832bb1f232446852d4df0d7c9be888d9fc64da900b93</cites><orcidid>0000-0001-6888-7080</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37296533$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Basolo, Alessio</creatorcontrib><creatorcontrib>Salvetti, Guido</creatorcontrib><creatorcontrib>Giannese, Domenico</creatorcontrib><creatorcontrib>Genzano, Susanna Bechi</creatorcontrib><creatorcontrib>Ceccarini, Giovanni</creatorcontrib><creatorcontrib>Giannini, Riccardo</creatorcontrib><creatorcontrib>Sotgia, Gianluca</creatorcontrib><creatorcontrib>Fierabracci, Paola</creatorcontrib><creatorcontrib>Piaggi, Paolo</creatorcontrib><creatorcontrib>Santini, Ferruccio</creatorcontrib><title>Obesity, Hyperfiltration, and Early Kidney Damage: A New Formula for the Estimation of Creatinine Clearance</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Abstract
Context
Glomerular hyperfiltration may represent a direct pathogenetic link between obesity and kidney disease. The most widely used methods to estimate creatine clearance such as Cockroft–Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) have not been validated in subjects with obesity.
Objective
The performance of prediction formulas was compared with measured creatinine clearance (mCrCl) in subjects with obesity.
Methods
The study population included 342 patients with obesity (mean BMI 47.6 kg/m2) without primary kidney disease. A urine collection was performed over 24 hours for measurement of CrCl.
Results
mCrCl increased with body weight. The CG formula showed an overestimation at high CrCl, whereas an underestimation resulted from CKD-EPI and MDRD. To improve the accuracy of estimated CrCl (eCrCl), a new CG-based formula was developed:53+0.7×(140−Age)×Weight/(96xSCr)×(0.85iffemale)A cut-off point for BMI of 32 kg/m2 was identified, at which the new formula may be applied to improve eCrCl.
Conclusion
In patients with obesity the glomerular filtration rate increases with body weight, and it is associated with the presence of albuminuria, suggesting an early kidney injury. We propose a novel formula that improves the accuracy of eCrCl to avoid missed diagnoses of hyperfiltration in patients with obesity.</description><subject>Body weight</subject><subject>Chronic kidney failure</subject><subject>Comparative analysis</subject><subject>Creatine</subject><subject>Creatinine</subject><subject>Development and progression</subject><subject>Epidemiology</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Kidney</subject><subject>Kidney diseases</subject><subject>Kidney Function Tests</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Population studies</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Type 2 diabetes</subject><issn>0021-972X</issn><issn>1945-7197</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNqFkc9rFDEcxYModrt69SgBLwqdNj83ibdl3Vqx2IuCt5BJvrNOnZmsyQwy_31Td1WQguTwzeHzHo_3EHpByTlllFz4rh2gvwg7Fzgnj9CCGiErRY16jBaEMFoZxb6eoNOcbwmhQkj-FJ1wxcxKcr5A329qyO04n-GreQ-pabsxubGNwxl2Q8Bbl7oZf2zDADN-53q3g7d4jT_BT3wZUz91Djcx4fEb4G0e2_6XFMcGbxKU_1DC4U0HLrnBwzP0pHFdhufHu0RfLrefN1fV9c37D5v1deXFSowVSMlq3yjPa6-0JhwCNZqzuqYN40yIlZYsiNCQoLypQWsdTONXIjhDSG34Er0--O5T_DFBHm3fZg9d5waIU7ZMs-KhBBEFffUPehunNJR0lhkpOaGK67_UznVg26GJpSR_b2rXSkkjtSwxl-j8Aaq8AH3r4wClXHhQ4FPMOUFj96lUmGZLib1f1x7Wtcd1i-DlMe1U9xD-4L_nLMCbAxCn_f_M7gBScK5F</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Basolo, Alessio</creator><creator>Salvetti, Guido</creator><creator>Giannese, Domenico</creator><creator>Genzano, Susanna Bechi</creator><creator>Ceccarini, Giovanni</creator><creator>Giannini, Riccardo</creator><creator>Sotgia, Gianluca</creator><creator>Fierabracci, Paola</creator><creator>Piaggi, Paolo</creator><creator>Santini, Ferruccio</creator><general>Oxford University Press</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6888-7080</orcidid></search><sort><creationdate>20231201</creationdate><title>Obesity, Hyperfiltration, and Early Kidney Damage: A New Formula for the Estimation of Creatinine Clearance</title><author>Basolo, Alessio ; Salvetti, Guido ; Giannese, Domenico ; Genzano, Susanna Bechi ; Ceccarini, Giovanni ; Giannini, Riccardo ; Sotgia, Gianluca ; Fierabracci, Paola ; Piaggi, Paolo ; Santini, Ferruccio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-e552bcf7c3bc78803ed19832bb1f232446852d4df0d7c9be888d9fc64da900b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Body weight</topic><topic>Chronic kidney failure</topic><topic>Comparative analysis</topic><topic>Creatine</topic><topic>Creatinine</topic><topic>Development and progression</topic><topic>Epidemiology</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Kidney</topic><topic>Kidney diseases</topic><topic>Kidney Function Tests</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Population studies</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Basolo, Alessio</creatorcontrib><creatorcontrib>Salvetti, Guido</creatorcontrib><creatorcontrib>Giannese, Domenico</creatorcontrib><creatorcontrib>Genzano, Susanna Bechi</creatorcontrib><creatorcontrib>Ceccarini, Giovanni</creatorcontrib><creatorcontrib>Giannini, Riccardo</creatorcontrib><creatorcontrib>Sotgia, Gianluca</creatorcontrib><creatorcontrib>Fierabracci, Paola</creatorcontrib><creatorcontrib>Piaggi, Paolo</creatorcontrib><creatorcontrib>Santini, Ferruccio</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Basolo, Alessio</au><au>Salvetti, Guido</au><au>Giannese, Domenico</au><au>Genzano, Susanna Bechi</au><au>Ceccarini, Giovanni</au><au>Giannini, Riccardo</au><au>Sotgia, Gianluca</au><au>Fierabracci, Paola</au><au>Piaggi, Paolo</au><au>Santini, Ferruccio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obesity, Hyperfiltration, and Early Kidney Damage: A New Formula for the Estimation of Creatinine Clearance</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2023-12-01</date><risdate>2023</risdate><volume>108</volume><issue>12</issue><spage>3280</spage><epage>3286</epage><pages>3280-3286</pages><issn>0021-972X</issn><issn>1945-7197</issn><eissn>1945-7197</eissn><abstract>Abstract
Context
Glomerular hyperfiltration may represent a direct pathogenetic link between obesity and kidney disease. The most widely used methods to estimate creatine clearance such as Cockroft–Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) have not been validated in subjects with obesity.
Objective
The performance of prediction formulas was compared with measured creatinine clearance (mCrCl) in subjects with obesity.
Methods
The study population included 342 patients with obesity (mean BMI 47.6 kg/m2) without primary kidney disease. A urine collection was performed over 24 hours for measurement of CrCl.
Results
mCrCl increased with body weight. The CG formula showed an overestimation at high CrCl, whereas an underestimation resulted from CKD-EPI and MDRD. To improve the accuracy of estimated CrCl (eCrCl), a new CG-based formula was developed:53+0.7×(140−Age)×Weight/(96xSCr)×(0.85iffemale)A cut-off point for BMI of 32 kg/m2 was identified, at which the new formula may be applied to improve eCrCl.
Conclusion
In patients with obesity the glomerular filtration rate increases with body weight, and it is associated with the presence of albuminuria, suggesting an early kidney injury. We propose a novel formula that improves the accuracy of eCrCl to avoid missed diagnoses of hyperfiltration in patients with obesity.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>37296533</pmid><doi>10.1210/clinem/dgad330</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-6888-7080</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0021-972X |
| ispartof | The journal of clinical endocrinology and metabolism, 2023-12, Vol.108 (12), p.3280-3286 |
| issn | 0021-972X 1945-7197 1945-7197 |
| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Body weight Chronic kidney failure Comparative analysis Creatine Creatinine Development and progression Epidemiology Glomerular Filtration Rate Humans Kidney Kidney diseases Kidney Function Tests Medical research Medicine, Experimental Obesity Obesity - complications Population studies Renal Insufficiency, Chronic - diagnosis Type 2 diabetes |
| title | Obesity, Hyperfiltration, and Early Kidney Damage: A New Formula for the Estimation of Creatinine Clearance |
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