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Renal function assessment in patients with systemic lupus erythematosus

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Abstract

Few studies have evaluated the glomerular filtration rate (GFR) in patients with systemic lupus erythematosus (SLE). Even though the National Kidney Foundation (NKF) suggests using the equations to estimate GFR, rheumatologists continue using creatinine clearance (CCl). The main objective of our study was the assessment of different equations to estimate GFR in patients with SLE: Simplified MDRD study equation (sMDRD), CCl, Cockcroft Gault (CG), CG calculated with ideal weight (CGi), Mayo Clinic Quadratic (MCQ), and Chronic Kidney Disease Epidemiology Collaboration Equation (CKD-EPI). CKD-EPI was considered as the reference standard, and it was compared with the other equations to evaluate bias, correlation (r), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), percentage of measurement of GFR between 70–130% of GFR measured through CKD-EPI (P30) and to compute the ROC curves. Adequacy of the 24-h urine collection was evaluated. To classify patients into GFR < 60 ml/min/1.73 m2, the best sensitivity and NVP were obtained with sMDRD: the best PPV and specificity with MCQ. P30 was 99.3% with sMDRD, 77.5% CCl, 91.7% CG, 96.7% CGi, and 77.2% with MCQ. The lowest bias was for sMDRD and the highest for CCl. Only 159 (52.6%) urine collections were considered adequate, and when these patients were re-evaluated, the statistical results improved for CCl. CGi was better in general than CG. CCl should not be considered as an adequate GFR estimation. Ideal weight is better than real weight to calculate GFR through CG in patients with SLE.

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Acknowledgments

The authors acknowledge the helpful suggestions of Mr. John W. Covey.

Conflict of interest

All authors declare do not have any interest disclosure.

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Authors and Affiliations

  1. Regional Unit of Rheumatology and Osteoporosis, Central Hospital “Dr. Ignacio Morones Prieto” and Faculty of Medicine, Universidad Autónoma de San Luis Potosí, Carranza 2395, 78240, San Luis Potosí, México

    Marco Ulises Martínez-Martínez, Martín Magaña-Aquino, Enrique Cuevas-Orta & Carlos Abud-Mendoza

  2. Nephrology and Transplantation Department, Central Hospital “Dr. Ignacio Morones Prieto” and Faculty of Medicine, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México

    Jaime Antonio Borjas-García & Lilia Llamazares-Azuara

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  1. Marco Ulises Martínez-Martínez
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  2. Jaime Antonio Borjas-García
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  3. Martín Magaña-Aquino
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  4. Enrique Cuevas-Orta
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  5. Lilia Llamazares-Azuara
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  6. Carlos Abud-Mendoza
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Correspondence to Carlos Abud-Mendoza.

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Martínez-Martínez, M.U., Borjas-García, J.A., Magaña-Aquino, M. et al. Renal function assessment in patients with systemic lupus erythematosus. Rheumatol Int 32, 2293–2299 (2012). https://doi.org/10.1007/s00296-011-1940-9

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  • DOI: https://doi.org/10.1007/s00296-011-1940-9

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