La indexación a la superficie corporal disminuye la estimación de la velocidad de filtración glomerular y aumenta la severidad en la clasificación de la enfermedad renal crónica en la población con sobrepeso y obesidad

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dc.catalogadordfo
dc.contributor.authorVega, Jorge
dc.contributor.authorHuidobro, E. Juan Pablo
dc.contributor.authorSepulveda Palamara, Rodrigo Andrés
dc.date.accessioned2025-03-20T18:00:48Z
dc.date.available2025-03-20T18:00:48Z
dc.date.issued2024
dc.description.abstractGlomerular filtration rate estimates are usually indexed to a standard body surface area (BSA) of 1.73 m2. This allows comparing values of individuals of different sizes but has the potential of affecting individuals with extremes BSA. Aim: evaluating the differences in GFR estimates with or without indexing for BSA in a large cohort of ambulatory pa-tients grouped by different body mass index (BMI) and how indexing affects CKD classification. Methods: demographic and anthropometric data of 390 patients evaluated with ambulatory 24-hour creatinine clearance were registered in an anonymous database. Patients were divided in 3 groups according to BMI (18-24.9; 25-29.9; >30 kg/m2). GFR was estimated using creatinine clearance (CrCl), CKD-EPI 2009 and 2021 equations, both indexed to a standardized BSA of 1.73 m2and using the actual BSA of the patients. CKD classification was per-formed with and without indexing. Results: 224 of 390 patients were men (57.4%). 103 (26.4%) had normal BMI (group 1), 193 (49.5%) BMI of 25-29.9 (group 2) and 94 (24.1%) had BMI of 30 or more kg/m2 (group 3). Mean CrCl was 67.9 +/- 32.7 ml/min. Indexed to a BSA of 1.73 m2 CrCl was 64.8 +/- 30.5 ml/min (difference of -3.1 ml/min) (p< 0.001). The difference between real and indexed CrCl was +2.2 ml/min, -2.9 ml/min y -9.3 ml/min in groups 1, 2 and 3, respectively. Real CrCl was significantly higher in group 3 compared to group 1. Indexed ClCr was similar between the 3 groups. GFR estimation using equations was over 2 mL/min higher when removing indexation for standard BSA. Group 1 had higher indexed GFR estimates than groups 2 and 3. However, when removing indexing the 3 groups had similar GFR estimates. Classification of CKD was significantly affected by removing indexing, with almost 20% of the patients changing CKD stage. Diagnosis of GFR <60 mL/min was less frequent when removing indexing. Conclusion: Indexing to standard BSA lowers GFR estimation in overweight and obese patients, leading to a higher prevalence of GFR < 60 mL/min and CKD diagnosis
dc.fechaingreso.objetodigital2025-03-20
dc.fuente.origenWOS
dc.identifier.doi10.4067/s0034-98872024000700798
dc.identifier.eissn0717-6163
dc.identifier.issn0034-9887
dc.identifier.urihttps://doi.org/10.4067/s0034-98872024000700798
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/102884
dc.identifier.wosidWOS:001358098900006
dc.information.autorucEscuela de Medicina; Sepulveda Palamara Rodrigo Andres; 0000-0002-9618-3686; 252768
dc.issue.numero7
dc.language.isoes
dc.nota.accesoContenido completo
dc.pagina.final807
dc.pagina.inicio798
dc.revistaRevista médica de Chile
dc.rightsacceso abierto
dc.subjectBody Mass Index
dc.subjectGlomerular Filtration Rate
dc.subjectKidney Failure
dc.subjectChronic
dc.subjectRenal Insufficiency
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleLa indexación a la superficie corporal disminuye la estimación de la velocidad de filtración glomerular y aumenta la severidad en la clasificación de la enfermedad renal crónica en la población con sobrepeso y obesidad
dc.typeartículo
dc.volumen152
sipa.codpersvinculados252768
sipa.trazabilidadWOS;2024-11-30
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