COMPARISON OF COCKROFT-GAULT FORMULA AND CREATININE LEVEL IN RISK STRATIFICATION OF OUT-WARD PATIENTS WITH ARTERIAL HYPERTENSION | XVI. výroční sjezd České kardiologické společnosti

Introduction: Impaired renal function is an independent risk factor for cardiac events. For its evaluation is recommended to calculate glomerular filtration (GF) using Cockcroft-Gault formula. In ambulatory praxis is calculation of GF often underestimated, especially in patients with creatinine level in reference range.
Method: We compared meaning of calculated GF and quartiles of creatinine (Q-CREA) in reference range (≤ 135 μmol/l) on consideration of classic risk factors and absolute risk in pts with arterial hypertension (AH).
Results: In multicentric project were enrolled 558 out-ward pts (M-39.2%; F-60.8%) with AH (162.9±17.4/94.3±8.8 mm Hg) with CREA≤ 135 μmol/l. Calculated GF identified only 56.8% of pts in 1.grade, 33.9% were in 2. grade, res. 8.1% in 3. grade of renal impairement (K/DOQI). Pts in 3.grade of K/DOQI exhibited significantly higher absolute risk (acc. to SCORE) in comparison with 4Q-CREA : 6.20 vs. 6.08 (p<0.05). K/DOQI distribution shown higher statistical between-subjects contrasts of classic risk factors in comparison with Q-CREA distribution (Tabs 1 and 2).

Table1. Distribution of classic risk factors acc. to Q-CREA

                         Age     SBP/ DBP      LDL         HDL         TG
Q-CREA            [yrs]    [mmHg]          [mmol/l]    [mmol/l]    [mmol/l]
1                      62.5    161.2/ 92.1    3.29         1.40        1.95
2                       61.8    163.6/ 94.6    3.31         1.39        2.10
3                       61.7    163.1/ 95.8    3.34         1.33        2.35
4                      61.7    163.5/ 94.9    3.44         1.34        2.23

Signif                NS       NS   0.02       NS            NS         0.001

Table 2. Distribution of classic risk factors acc. to K/DOQI.
                       Age      SBP/ DBP      LDL          HDL       TG
K/DOQI            [yrs]     [mmHg]          [mmol/l]     [mmol/l] [mmol/l]
1                      57.1     161.9/ 95.0    3.34         1.33         2.21
2                      66.9     163.6/ 93.4    3.44         1.43         2.13
3                      75.3     168.0/ 94.0    3.13         1.39         1.92

Signif               0.001    0.03   0.04   0.08 - NS   0.02        NS

Conclusion: Use of Cockroft-Gault formula in stratification of out-ward patients with arterial hypertension provide more relevant clinical information in comparison with consideration of creatinine in reference range.

COMPARISON OF COCKROFT-GAULT FORMULA AND CREATININE LEVEL IN RISK STRATIFICATION OF OUT-WARD PATIENTS WITH ARTERIAL HYPERTENSION Tématický okruh: Ambulantní péče
Typ: Poster - lékařský , Číslo v programu: 537


Kosmálová V.¹, Lietava J.², Hirnerová E.¹ ¹ II. interná klinika LF UK, Fakultná nemocnica NsP Staré Mesto, Bratislava, SR, ² 2-nd Department of Internal Medicine, Comenius University, Bratislava, SR
Introduction: Impaired renal function is an independent risk factor for cardiac events. For its evaluation is recommended to calculate glomerular filtration (GF) using Cockcroft-Gault formula. In ambulatory praxis is calculation of GF often underestimated, especially in patients with creatinine level in reference range. Method: We compared meaning of calculated GF and quartiles of creatinine (Q-CREA) in reference range (≤ 135 μmol/l) on consideration of classic risk factors and absolute risk in pts with arterial hypertension (AH). Results: In multicentric project were enrolled 558 out-ward pts (M-39.2%; F-60.8%) with AH (162.9±17.4/94.3±8.8 mm Hg) with CREA≤ 135 μmol/l. Calculated GF identified only 56.8% of pts in 1.grade, 33.9% were in 2. grade, res. 8.1% in 3. grade of renal impairement (K/DOQI). Pts in 3.grade of K/DOQI exhibited significantly higher absolute risk (acc. to SCORE) in comparison with 4Q-CREA : 6.20 vs. 6.08 (p<0.05). K/DOQI distribution shown higher statistical between-subjects contrasts of classic risk factors in comparison with Q-CREA distribution (Tabs 1 and 2). Table1. Distribution of classic risk factors acc. to Q-CREA Age SBP/ DBP LDL HDL TG Q-CREA [yrs] [mmHg] [mmol/l] [mmol/l] [mmol/l] 1 62.5 161.2/ 92.1 3.29 1.40 1.95 2 61.8 163.6/ 94.6 3.31 1.39 2.10 3 61.7 163.1/ 95.8 3.34 1.33 2.35 4 61.7 163.5/ 94.9 3.44 1.34 2.23 Signif NS NS 0.02 NS NS 0.001 Table 2. Distribution of classic risk factors acc. to K/DOQI. Age SBP/ DBP LDL HDL TG K/DOQI [yrs] [mmHg] [mmol/l] [mmol/l] [mmol/l] 1 57.1 161.9/ 95.0 3.34 1.33 2.21 2 66.9 163.6/ 93.4 3.44 1.43 2.13 3 75.3 168.0/ 94.0 3.13 1.39 1.92 Signif 0.001 0.03 0.04 0.08 - NS 0.02 NS Conclusion: Use of Cockroft-Gault formula in stratification of out-ward patients with arterial hypertension provide more relevant clinical information in comparison with consideration of creatinine in reference range.

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