Função renal no idoso: como estamos avaliando? concordância entre a equação do Berlin Initiative Study (BIS1), CKD-EPI, MDRD e COCKROFT-GAULT

Abstract

Correctly measuring the glomerular filtration rate in the elderly is of extreme clinical importance and remains a challenge to this day. Several formulas based on creatinine have been used for this purpose, but all have limitations in relation to the elderly population. The Berlin Initiative Study 1 (BIS 1) formula demonstrated good accuracy in a sample of European elderly people over 70 years of age. The objective of the present study was to evaluate the diagnostic performance of the BIS 1 equation, comparing it to the most used in our country (CKD-EPI, MDRD and Cockroft-Gault) in terms of equivalence and agreement, as well as its correlation with anthropometric and clinical variables of the population studied. Regarding methodology, we carried out a cross-sectional study, where data were analyzed using SPSS software for Macintosh, version 23 (Armonk, NY: IBM Corp.), GraphPad Prism, version 6.01 and R (R Core Team, 2022) and to analyze the agreement between the BIS 1 equation and the other estimators for GFR, the Bland-Altman method was used. We obtained a sample of 98 participants with a mean age of 75 ± 5, mostly male (51%). After the analyses, the CKD-EPI formula showed to have good correlation and agreement with the BIS 1 formula, which was developed and validated for the elderly population over 70 years of age, being a possibility of use in our environment until new evidence in regarding the topic come to light. The other equations presented lower and very similar performance between them. New validation studies are necessary to accurately assess the validity and superiority of the BIS 1 formula in our population.