Estimation of glomerular filtration rate by MDRD equation in athletes: role of body surface area |
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Authors: | Radoje Milic Alessandra Colombini Giovanni Lombardi Patrizia Lanteri Giuseppe Banfi |
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Institution: | (1) Faculty of Sport, Institute of Sport, University of Ljubljana, Gortanova 22, 1000 Ljubljana, Slovenia;(2) Laboratory of Cell Cultures and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy;(3) School of Medicine, University of Milan, Milan, Italy; |
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Abstract: | Creatinine-based equations to estimate the glomerular filtration rate (GFR) have recently been advocated over serum creatinine
values as a valuable tool to more accurately assess kidney function. The Cockcroft–Gault (CG) equation requires a body weight
parameter, whereas the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease
(MDRD) Study equations do not. In this study we evaluated the effect of the calculated body surface area (BSA) on MDRD values
in professional athletes characterized from different body mass index, gender, and sport discipline. Serum creatinine concentration
was measured by Jaffe reaction in 17 male rugby players and 28 male and 26 female swimmers, before the start of training and
throughout the competitive season. The values of estimated GFR (eGFR) calculated for creatinine determination by means of
CG and CDK-EPI with respect to MDRD formula showed a significant difference in different groups of athletes. The statistical
significance was confirmed for BSA-corrected MDRD-derived eGFR values in rugby players and in male swimmers, but not in female
swimmers, who showed a BSA close to the “standard” value of 1.73 m2 traditionally included in MDRD equation. The CG equation can overestimate the eGFR in healthy overweight subjects such as
rugby players, whereas the MDRD formula systematically underestimates it. The differences between the two equations increase
as a function of BMI, appearing highest in rugby players and lowest in female swimmers. Real BSA correction of the MDRD equation
could help to avoid an overestimation of renal excretory function in subjects with increased BSA. |
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