title: Cross-sectional evaluation of kidney function in hospitalized patients: estimated GFR versus renal scintigraphy.
abstract: OBJECTIVE
  Accurate staging of chronic kidney disease (CKD) is very important. We tried to identify difference in GFR evaluation between CKD-EPI and Gates method with renal scintigraphy and which variables are associated with these differences.
  
  
  METHODS
  We retrospectively reviewed the records of 341 patients who underwent dynamic renal scintigraphy in the last 5 years. Patients were categorized according to KDIGO staging I to V, using the eGFR calculated with the CKD-EPI equation. Secondarily, we stratified patients according to treatment with renin-angiotensin system (RAS) inhibitors.
  
  
  RESULTS
  Gates method tends to underestimate GFR especially in CKD stage I (mean -22.2 ml/min) and II (mean -12.5 ml/min). The division in quartiles of ages showed an underestimation of GFR only in the first quartile of age (< 50 years old). Gates method underestimation of GFR was more pronounced in stage I patients treated with RAS inhibitors (mean -34.6 ml/min). The same occurs in stage II, even though to a lesser extent.
  
  
  CONCLUSIONS
  The assessment of GFR by the Gates method must be carefully considered in the early stages of CKD, especially in younger patients. Moreover, the difference is more pronounced in patients treated with RAS inhibitors. Longitudinal studies will prove which method better predicts cardiovascular or renal events.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Santoro
authors.forename: Zaira
authors.initials: Z
authors.lastname: Zappulla
authors.forename: Angela
authors.initials: A
authors.lastname: Alibrandi
authors.forename: Milos Tomasello
authors.initials: MT
authors.lastname: Andulajevic
authors.forename: Maria
authors.initials: M
authors.lastname: Licari
authors.forename: Sergio
authors.initials: S
authors.lastname: Baldari
authors.forename: Michele
authors.initials: M
authors.lastname: Buemi
authors.forename: Valeria
authors.initials: V
authors.lastname: Cernaro
authors.forename: Alfredo
authors.initials: A
authors.lastname: Campennì
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D000465:Algorithms; D019412:Anatomy, Cross-Sectional; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D007677:Kidney Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012084:Renin-Angiotensin System / Q000187:drug effects; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003404:Creatinine