The estimated glomerular filtration rate (eGFR) is a predictor of important outcomes and its reduction has been associated with the risk of all-cause mortality in both general population and elderly patients. However while reduced renal function is common in older people, the best method for estimating GFR remains unclear, especially in an acute care setting. Most studies analyzing the accuracy of eGFR in the elderly were carried out in different heterogeneous settings. In this study, we compare the prognostic value of different formulas estimating GFR in predicting the risk of in-hospital morbidity and mortality within 3 months from discharge in elderly hospitalized patients. Data were extracted from “Registro Politerapia Società Italiana di Medicina Interna (REPOSI)”. Patients with available creatinine values at hospital admission were selected and eGFR was calculated according to the different formulas: Cockcroft-Gault, Modification of Diet in Renal Disease equation, Chronic Kidney Disease Epidemiology Collaboration, Berlin Initiative Study and Full Age Spectrum. 4621 patients were included in the analysis. Among these, 4.2% and 14.2% died during hospitalization and within 3 months from discharge, respectively. eGFR > 60 ml/min/1.73 m2 at admission was associated with a very low risk of mortality during the hospital stay and within 90 days from discharge, while an eGFR < 60 ml/min/1.73 m2 was associated with unfavorable outcomes, although with a poor level of accuracy (AUC 0.60–0.66). No difference in predictive power between different equations was found. Physicians should be aware of the prognostic role of eGFR in a comprehensive assessment of elderly in-patients.

Prognostic relevance of glomerular filtration rate estimation obtained through different equations in hospitalized elderly patients

Prisco, Domenico;Cappellini, Maria Domenica;Ferrari, Barbara;Guasti, Luigina;Castiglioni, Luana;Maresca, Andrea;Squizzato, Alessandro;Campiotti, Leonardo
Membro del Collaboration Group
;
Galanti, Giorgio;
2018-01-01

Abstract

The estimated glomerular filtration rate (eGFR) is a predictor of important outcomes and its reduction has been associated with the risk of all-cause mortality in both general population and elderly patients. However while reduced renal function is common in older people, the best method for estimating GFR remains unclear, especially in an acute care setting. Most studies analyzing the accuracy of eGFR in the elderly were carried out in different heterogeneous settings. In this study, we compare the prognostic value of different formulas estimating GFR in predicting the risk of in-hospital morbidity and mortality within 3 months from discharge in elderly hospitalized patients. Data were extracted from “Registro Politerapia Società Italiana di Medicina Interna (REPOSI)”. Patients with available creatinine values at hospital admission were selected and eGFR was calculated according to the different formulas: Cockcroft-Gault, Modification of Diet in Renal Disease equation, Chronic Kidney Disease Epidemiology Collaboration, Berlin Initiative Study and Full Age Spectrum. 4621 patients were included in the analysis. Among these, 4.2% and 14.2% died during hospitalization and within 3 months from discharge, respectively. eGFR > 60 ml/min/1.73 m2 at admission was associated with a very low risk of mortality during the hospital stay and within 90 days from discharge, while an eGFR < 60 ml/min/1.73 m2 was associated with unfavorable outcomes, although with a poor level of accuracy (AUC 0.60–0.66). No difference in predictive power between different equations was found. Physicians should be aware of the prognostic role of eGFR in a comprehensive assessment of elderly in-patients.
2018
www.elsevier.com/locate/ejim
eGFR; Elderly in-patients; Glomerular filtration rate estimation; Prognosis; Aged; Aged, 80 and over; Creatinine; Female; Humans; Italy; Male; Prognosis; Renal Insufficiency, Chronic; Glomerular Filtration Rate; Hospital Mortality; Hospitalization
Gallo, Paolo; De Vincentis, Antonio; Pedone, Claudio; Nobili, Alessandro; Tettamanti, Mauro; Gentilucci, Umberto Vespasiani; Picardi, Antonio; Mannucci, Pier Mannuccio; Incalzi, Raffaele Antonelli; Prisco, Domenico; Silvestri, Elena; Emmi, Giacomo; Bettiol, Alessandra; Caterina, Cenci; Biolo, Gianni; Zanetti, Michela; Guadagni, Martina; Zaccari, Michele; Chiuch, Massimiliano; Zaccari, Michele; Vanoli, Massimo; Grignani, Giulia; Pulixi, Edoardo Alessandro; Bernardi, Mauro; Bassi, Silvia Li; Santi, Luca; Zaccherini, Giacomo; Lupattelli, Graziana; Mannarino, Elmo; Bianconi, Vanessa; Paciullo, Francesco; Alcidi, Riccardo; Nuti, Ranuccio; Valenti, Roberto; Ruvio, Martina; Cappelli, Silvia; Palazzuoli, Alberto; Girelli, Domenico; Busti, Fabiana; Marchi, Giacomo; Barbagallo, Mario; Dominguez, Ligia; Cocita, Floriana; Beneduce, Vincenza; Plances, Lidia; Corrao, Salvatore; Natoli, Giuseppe; Mularo, Salvatore; Raspanti, Massimo; Cavallaro, Federica; Zoli, Marco; Lazzari, Ilaria; Brunori, Mattia; Fabbri, Elisa; Magalotti, Donatella; Arno, Raffaella; Pasini, Franco Laghi; Capecchi, Pier Leopoldo; Palasciano, Giuseppe; Modeo, Maria Ester; Di Gennaro, Carla; Cappellini, Maria Domenica; Maira, Diletta; Di Stefano, Valeria; Fabio, Giovanna; Seghezzi, Sonia; Mancarella, Marta; De Amicis, Margherita Migone; De Luca, Giacomo; Scaramellini, Natalia; Cesari, Matteo; Rossi, Paolo Dionigi; Damanti, Sarah; Clerici, Marta; Conti, Federica; Bonini, Giulia; Ottolini, Barbara Brignolo; Di Sabatino, Antonio; Miceli, Emanuela; Lenti, Marco Vincenzo; Pisati, Martina; Dominioni, Costanza Caccia; Murialdo, Giovanni; Marra, Alessio; Cattaneo, Federico; Pontremoli, Roberto; Beccati, Valentina; Nobili, Giulia; Secchi, Maria Beatrice; Ghelfi, Davide; Anastasio, Luigi; Sofia, Lucia; Carbone, Maria; Anastasio, Luigi; Sofia, Lucia; Carbone, Maria; Cipollone, Francesco; Guagnano, Maria Teresa; Valeriani, Emanuele; Rossi, Ilaria; Mancuso, Gerardo; Calipari, Daniela; Bartone, Mose; Delitala, Giuseppe; Berria, Maria; Pes, Chiara; Delitala, Alessandro; Muscaritoli, Maurizio; Molfino, Alessio; Petrillo, Enrico; Zuccala, Giuseppe; D'Aurizio, Gabriella; Romanelli, Giuseppe; Marengoni, Alessandra; Zucchelli, Alberto; Manzoni, Francesca; Volpini, Andrea; Picardi, Antonio; Gentilucci, Umberto Vespasiani; Gallo, Paolo; Dell'Unto, Chiara; Annoni, Giorgio; Corsi, Maurizio; Bellelli, Giuseppe; Zazzetta, Sara; Mazzola, Paolo; Szabo, Hajnalka; Bonfanti, Alessandra; Arturi, Franco; Succurro, Elena; Rubino, Mariangela; Tassone, Bruno; Sesti, Giorgio; Serra, Maria Grazia; Bleve, Maria Antonietta; Gasbarrone, Laura; Sajeva, Maria Rosaria; Brucato, Antonio; Ghidoni, Silvia; Fabris, Fabrizio; Bertozzi, Irene; Bogoni, Giulia; Rabuini, Maria Victoria; Cosi, Elisabetta; Scarinzi, Paolo; Amabile, Annalisa; Omenetto, Elisabetta; Prandini, Tancredi; Manfredini, Roberto; Fabbian, Fabio; Boari, Benedetta; De Giorgi, Alfredo; Tiseo, Ruana; De Giorgio, Roberto; Paolisso, Giuseppe; Rizzo, Maria Rosaria; Borghi, Claudio; Strocchi, Enrico; Ianniello, Eugenia; Soldati, Mario; Sabba, Carlo; Vella, Francesco Saverio; Suppressa, Patrizia; Agosti, Pasquale; Schilardi, Andrea; Loparco, Francesca; De Vincenzo, Giovanni Michele; Comitangelo, Alessio; Amoruso, Emanuele; Fenoglio, Luigi; Falcetta, Andrea; Bracco, Christian; Fracanzani, Anna L.; Fargion, Silvia; Tiraboschi, Silvia; Cespiati, Annalisa; Oberti, Giovanna; Sigon, Giordano; Peyvandi, Flora; Rossio, Raffaella; Ferrari, Barbara; Colombo, Giulia; Monzani, Valter; Savojardo, Valeria; Folli, Christian; Ceriani, Giuliana; Salerno, Francesco; Pallini, Giada; Dallegri, Franco; Ottonello, Luciano; Liberale, Luca; Caserza, Lara; Salam, Kassem; Liberato, Nicola Lucio; Tognin, Tiziana; Bianchi, Giovanni Battista; Giaquinto, Sabrina; Purrello, Francesco; Di Pino, Antonino; Piro, Salvatore; Rozzini, Renzo; Falanga, Lina; Spazzini, Elena; Ferrandina, Camillo; Montrucchio, Giuseppe; Petitti, Paolo; Peasso, Paolo; Favale, Edoardo; Poletto, Cesare; Salmi, Raffaella; Gaudenzi, Piergiorgio; Violi, Francesco; Perri, Ludovica; Landolfi, Raffaele; Montalto, Massimo; Mirijello, Antonio; Guasti, Luigina; Castiglioni, Luana; Maresca, Andrea; Squizzato, Alessandro; Campiotti, Leonardo; Grossi, Alessandra; Bertolotti, Marco; Mussi, Chiara; Lancellotti, Giulia; Libbra, Maria Vittoria; Dondi, Giulia; Pellegrini, Elisa; Carulli, Lucia; Galassi, Matteo; Grassi, Yasmine; Perticone, Francesco; Perticone, Maria; Battaglia, Rosa; Filice, Marco; Maio, Raffaele; Stanghellini, Vincenzo; Ruggeri, Eugenio; del Vecchio, Sara; Salvi, Andrea; Leonardi, Roberto; Damiani, Giampaolo; Capeci, William; Gabrielli, Armando; Mattioli, Massimo; Martino, Giuseppe Pio; Biondi, Lorenzo; Pettinari, Pietro; Ghio, Riccardo; Dal Col, Anna; Minisola, Salvatore; Colangelo, Luciano; Cilli, Mirella; Labbadia, Giancarlo; Afeltra, Antonella; Marigliano, Benedetta; Pipita, Maria Elena; Castellino, Pietro; Zanoli, Luca; Pignataro, Samuele; Gennaro, Alfio; Blanco, Julien; Saracco, Valter; Fogliati, Marisa; Bussolino, Carlo; Mete, Francesca; Gino, Miriam; Cittadini, Antonio; Vigorito, Carlo; Arcopinto, Michele; Salzano, Andrea; Bobbio, Emanuele; Marra, Alberto Maria; Sirico, Domenico; Moreo, Guido; Gasparini, Francesca; Prolo, Silvia; Pina, Gloria; Ballestrero, Alberto; Ferrando, Fabio; Berra, Sergio; Dassi, Simonetta; Nava, Maria Cristina; Graziella, Bruno; Baldassarre, Stefano; Fragapani, Salvatore; Gruden, Gabriella; Galanti, Giorgio; Mascherini, Gabriele; Petri, Cristian; Stefani, Laura; Girino, Margherita; Piccinelli, Valeria; Nasso, Francesco; Gioffre, Vincenza; Pasquale, Maria; Scattolin, Giuseppe; Martinelli, Sergio; Turrin, Mauro; Sechi, Leonardo; Catena, Cristina; Colussi, Gianluca; Passariello, Nicola; Rinaldi, Luca; Berti, Franco; Famularo, Giuseppe; Tarsitani, Patrizia; Castello, Roberto; Pasino, Michela; Ceda, Gian Paolo; Maggio, Marcello Giuseppe; Morganti, Simonetta; Artoni, Andrea; Del Giacco, Stefano; Firinu, Davide; Losa, Francesca; Paoletti, Giovanni; Costanzo, Giulia; Montalto, Giuseppe; Licata, Anna; Malerba, Valentina; Montalto, Filippo Alessandro; Lasco, Antonino; Basile, Giorgio; Catalano, Antonino; Malatino, Lorenzo; Stancanelli, Benedetta; Terranova, Valentina; Di Marca, Salvatore; Di Quattro, Rosario; La Malfa, Lara; Caruso, Rossella; Mecocci, Patrizia; Ruggiero, Carmelinda; Boccardi, Virginia; Meschi, Tiziana; Lauretani, Fulvio; Ticinesi, Andrea; Nouvenne, Antonio; Minuz, Pietro; Fondrieschi, Luigi; Pirisi, Mario; Fra, Gian Paolo; Sola, Daniele; Porta, Massimo; Riva, Piero; Quadri, Roberto; Larovere, Erica; Novelli, Marco; Scanzi, Giorgio; Mengoli, Caterina; Provini, Stella; Ricevuti, Laura; Simeone, Emilio; Scurti, Rosa; Tolloso, Fabio; Tarquini, Roberto; Valoriani, Alice; Dolenti, Silvia; Vannini, Giulia; Tedeschi, Alberto; Trotta, Lucia; Volpi, Riccardo; Bocchi, Pietro; Vignali, Alessandro; Harari, Sergio; Lonati, Chiara; Cattaneo, Mara; Duque Nieves, Ramirez; Molinero Alberto, Muela; Requejo Pedro, Abad; Pelaez Vanessa, Lopez; Lara, Tamargo; Viros Xavier, Corbella; Francesc, Formiga; Manglano Jesus, Diez; Tello Esperanza, Bejarano; Behamonte Esther, Del Corral; Puras Maria, Sevil; Romero, Manuel; Llorente Blanca, Pinilla; Gonzalez-Cobos Cristina, Lopez; Victoria, Villalba Garcia M.; Saez, Lopez; Bosco, Juan; Baena Susana, Sanz; Gallego Marta, Arroyo; Becerra Concepcion, Gonzalez; Moyano Antonio, Fernandez; Gomez Hernandez, Mercedes; Poyato Borrego, Manuel; Cuadros Raquel, Pacheco; Rojas Florencia, Perez; Olid Beatriz, Garcia; Garcia Sara, Carrascosa; Cervellera Alfonso, Gonzalez-Cruz; Martinez Marta, Peinado; Cantero Alberto, Ruiz; Arraigosa Antonio, Albarracin; Guerrero Montserrat, Godoy; Miguel Angel, Baron Ramos; Jose Manuel, Machin; Veleiro Ignacio, Novo; Suarez Lucia, Alvela; Alfonso, Lopez; Bran David, Rubal; Vazquez Iria, Iniguez; Prego Monica, Rios
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2086346
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