Acute kidney injury (AKI) and chronic kidney disease (CKD) can both occur in cirrhotic people. Therefore, in cirrhotic patients, renal functional assessment is essential. However, in contrast to other patient groups, these patients’ blood creatinine and urea levels and measured or estimated glomerular filtration rates were not accurate indicators of their renal function. In the current study, 4 novel equations were developed and evaluated for the screening of stable cirrhotic individuals for CKD and chronic kidney insufficiency (CKI).
In the study, 175 stable adult patients with cirrhosis had their estimated GFR (CKD-EPI creatinine and cystatin equations) recorded, and these patients were categorized as having or not having CKD and CKI after being examined by two independent nephrologists. The Student’s t-test for two independent groups was used to determine the variables with the significant discriminating capacity to identify CKD and CKI (based on creatinine and cystatin) in order to derive the renal function equations. These variables were further validated by the Lambda test of Wilks.
Creatinine in the CKD equation was calculated as follows:
- CKD equation (creatinine) = 7.094238–0.043104 × CKD-EPI creatinine – 0.057537 × haematocrit.
- CKD equation (cystatin) = 8.375074–0.117218 × CKD-EPI cystatin.
- CKI equation (creatinine) = 0.428389–0.043214 × CKD-EPI creatinine +0.183051 × Child-Pugh score + 0.050162 × age (in years).
- CKI equation (cystatin) = 9.169579–0.139319 × CKD-EPI cystatin.
For the purpose of diagnosing chronic kidney disease and chronic renal insufficiency in cirrhotic individuals, simple and trustworthy equations have been developed.
Reference: onlinelibrary.wiley.com/doi/10.1111/nep.14075
