[Evaluation of "hidden" renal insufficiency by abbreviated-MDRD equation].
BACKGROUND
Early detection of renal insufficiency (RI) allows to start therapies in order to slow renal disease progression and modify associated risk factors. Serum creatinine (Cr) is not a good marker of renal insufficiency. Some patients with significant renal failure can show Cr values in the normal range. Cr derived equations can help us to estimate glomerular filtration rate (GFR) more precisely. The aim of this study has been to know the utility of abbreviated-MDRD equation to detect "hidden" (non detected by Cr) renal insufficiency in patients attending general practices.


METHODS
Patients with blood samples attending general practices in two localities were studied during one year. In all, one thousand patients were included. Collected data were: age, sex, creatinine, haemoglobin, previous diagnosis of arterial hypertension or diabetes mellitus and chronic abuse of analgesic. Abbreviated MDRD equation was used to know GFR. "Hidden" RI was defined when GFR was lower than 60 ml/min/1.73 m2 and Cr was in the normal range.


RESULTS
104 (10.4%) patients showed "hidden" RI. Patients with "hidden" RI were older (70.7 +/- 12.5 vs. 52.4 +/- 18.6 years, p < 0.001), were more frequently women (86.5% vs 62.4%, p < 0.001) and hypertensive (46.1% vs. 23.6%, p < 0.001) and showed lower levels of haemoglobin (13.8 +/- 1.3 vs 14.2 +/- 1.3 g/dl, p = 0.001).


CONCLUSIONS
In patients attending general practices abbreviated-MDRD allows to recognise a significant number of patients with "hidden" renal insufficiency, but with normal range creatinine. Patientes with "hidden" renal insufficiency are more frequently older, women and hypertensive.
Rodrigo
M P
MP
Centro de Salud Plaza del Ejército, Valladolid. prodrigo@compalencia.org
Andrés
M R
MR
D000368:Aged; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000175:diagnosis*