Obesity, Hyperfiltration, and Early Kidney Damage: A New Formula for the Estimation of Creatinine Clearance
Authors' conclusion
In patients with obesity the glomerular filtration rate increases with body weight, and it is associated with the presence of albuminuria, suggesting an early kidney injury. We propose a novel formula that improves the accuracy of eCrCl to avoid missed diagnoses of hyperfiltration in patients with obesity.
Study context
- Population
- Patients with obesity (mean BMI 47.6 kg/m²) without primary kidney disease
- Participants
- 342 patients
- Comparison
- Prediction formulas vs measured 24-hour creatinine clearance
- Outcome
- Performance of prediction formulas vs measured creatinine clearance
Performance
As reported in the abstract
Agreement of estimated with measured CrCl
- Measured creatinine clearance (mCrCl) increased with body weight
- Cockroft-Gault (CG) overestimated at high CrCl
- CKD-EPI and Modification of Diet in Renal Disease (MDRD) underestimated
Further findings
New CG-based formula for eCrCl
- New formula
- 53+0.7×(140-Age) × Weight/(96xSCr) × (0.85iffemale)
- BMI cut-off for applying new formula
- 32 kg/m²
Original publication
Obesity, Hyperfiltration, and Early Kidney Damage: A New Formula for the Estimation of Creatinine Clearance. J Clin Endocrinol Metab. Published 10 June 2023. doi:10.
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