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Master Thesis

Performances des formules d'estimation du débit de filtration glomérulaire chez les patients obèses réunionnais

Abstract : Introduction: obesity is associated with a higher risk of chronic kidney disease (CKD). Adequate estimation of glomerular filtration rate (GFR) is necessary to identify affected patients. Formulas are not validated in patients with body mass index > 30 kg/m². In the general population of Reunion Island, the performances of formulas are lower than in the European population. Methods: we compared performances of 6 formulas with not indexed measured GFR in 192 reunion obese patients (by51 Cr-EDTA urinary clearance). Each formulas was deindexed to either body surface area (BSA) calculated using real body weight or using Lorentz ideal body weight. Mean bias, precision and accuracy were calculated. Best formula was assessed for each GFR level, and characterized in CKD diagnosis and glomerular hyperfiltration (GFR > 135 ml/min) diagnosis. Results: deindexed by BSA using ideal body weight CKD-EPI (CKD-EPIi) showed the best performances (absolute bias = -1.5 ml/min, relative bias = 15%, precision = 15 ml/min and accuracy 30 = 92%). Deindexed by BSA using real body weight formula’s performances were all inferiors to deindexed by BSA using ideal body weight formula’s performances. CKD-EPIi’s positive predictive value for CKD diagnosis was 100% whereas negative predictive value was 79% (CKD defined by GFR < 60 ml/min and/or albuminuria > 3 mg/mmol). CKD-EPIi identified only 11% of patients with glomerular hyperfiltration. Conclusion: deindexed by BSA using ideal body weight CKD-EPI is the best formula in estimation of non-indexed measured GFR in reunion obese patients. Its performances are equivalent to validated formulas in general population.
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Emmanuel Barange. Performances des formules d'estimation du débit de filtration glomérulaire chez les patients obèses réunionnais. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02438462⟩

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