Volume 17 Supplement 2
Estimated glomerular filtration rate based on hospital discharge creatinine may significantly overestimate renal function and underestimate chronic kidney disease in survivors of critical illness
© Kolic et al.; licensee BioMed Central Ltd. 2013
Published: 19 March 2013
Acute kidney injury (AKI) complicates over 50% of ICU admissions. Episodes of AKI are a major risk factor for development or progression of chronic kidney disease (CKD); however, methods of estimated glomerular filtration rate (eGFR) may be poorly calibrated to survivors of critical illness who may have reduced muscle mass. We hypothesized that eGFR may underestimate rates and severity of CKD in ICU survivors.
A retrospective observational study of renal function in all patients admitted to a London teaching hospital ICU for ≥5 days and surviving to hospital discharge in 2011. We excluded cases with current or new diagnosis of end-stage renal disease or renal transplant. We assessed AKI in ICU by KDIGO 1 criteria and hospital discharge eGFR by the CKD-EPI equation. For comparison we assumed a normal GFR in a healthy individual as 120 ml/minute/1.73 m2 at age 20 decreasing by 0.8 per year over age 20.
eGFR may overestimate renal function in survivors of critical illness confounding identification of CKD in this at-risk population. Prospective studies with measurement of actual GFR are required to assess the burden of CKD in survivors of critical illness.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.