A simple estimation of glomerular filtration rate in diabetes patients from serum creatinine
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Abstract
Serum creatinine level is frequently used to estimate the renal function; however, some diabetes patients can have significantly decreased glomerular filtration rates (GFR) despite normal range serum creatinine values, making the recognition of early stage chronic renal dysfunction more difficult. This retrospective study recruited all type 2 diabetes patients attending the primary care unit medicine practice, Amphoe Muang, Surin Province in 2014, their serum creatinine, urine micro and macro-albumin and the GFR calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation were collected to estimate the kidney function. Of 3,231 diabetes patients screened, 1,484 (45.9%) of them met the inclusion criteria of chronic kidney disease (CKD). Among them, renal failure stage 3 or more (GFR <60 ml/min) was present in 45.5% and severe renal failure stage 4 or more (GFR <30 ml/min) was present in 3.9%. The old criterion of kidney failure, serum creatinine >2.0 mg/dl, had a sensitivity of 45.8% and the specificity of 99.9% for detecting CKD stage 3 or more and the sensitivity of 4.1% for general CKD. Only 322 (47.6%) of the 676 diabetes patients with renal failure had albuminuria more than 30 mg%. It was concluded that earlier stages of CKD could be early detected for planning of management based on the combination of kidney damage by using albuminuria and decreased calculated GFR.
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