SciELO - Scientific Electronic Library Online

 
vol.32 número1Biomarcadores precoces de fracaso renal agudo tras angiografía coronaria o cirugía cardíaca en pacientes con síndrome coronario o fallo cardíaco agudosDetección precoz de la enfermedad renal crónica: colaboración entre nefrólogos y especialistas de atención primaria de Belgrado índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Articulo

Indicadores

Links relacionados

  • En proceso de indezaciónCitado por Google
  • No hay articulos similaresSimilares en SciELO
  • En proceso de indezaciónSimilares en Google

Compartir


Nefrología (Madrid)

versión impresa ISSN 0211-6995

Resumen

CANDELA-TOHA, A.M. et al. The calculation of baseline serum creatinine overestimates the diagnosis of acute kidney injury in patients undergoing cardiac surgery. Nefrología (Madr.) [online]. 2012, vol.32, n.1, pp.53-58. ISSN 0211-6995.

Introduction and objectives: The current definition and classification of acute kidney injury is based on consensus criteria (RIFLE and AKIN systems). Creatinine is the most commonly used of the recommended parameters (creatinine, glomerular filtration rate and diuresis). If the baseline value is not known, it can be calculated based on the simplified MDRD equation, assuming a filtration rate of 75ml/min/1.73m2 for the calculation. The aim of this study was to evaluate the diagnostic impact of using estimated baseline creatinine compared to the actual value measured in patients undergoing cardiac surgery. Methods: Analysis of patients undergoing major cardiac surgery, who were prospectively included in a database. The maximum RIFLE stage reached was calculated for each patient using the measured and estimated baseline creatinine levels. The impact on the diagnosis was analysed using intraclass correlation coefficients, concordance analysis and Bland-Altman plots. Results: The incidence of postoperative acute kidney injury in 2103 cases between 2002 and 2007 was 29.1%, according to estimated creatinine (14.3% with the measure). This represents an overestimation of 104%, with an intraclass correlation of 0.12. By excluding patients with known chronic kidney disease (glomerular filtration rate [<60ml/min/1.73m2), both the overestimation (2.4%) and the correlation (0.57) improved. Conclusions: The calculation of baseline creatinine using the MDRD equation overestimates the incidence of acute kidney injury after cardiac surgery, and is an inadequate method for detection when the baseline value is unknown.

Palabras clave : Cardiac surgery; Acute renal failure; Acute kidney injury; Serum creatinine; RIFLE.

        · resumen en Español     · texto en Español     · Español ( pdf )

 

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons