It's time for a fivesome.
t’s time for a fivesome. Commentary to: “The predictive value of five
glomerular filtration rate formulas for long-term mortality in patients
undergoing coronary artery bypass grafting” Coronary artery disease is
an extremely common condition and coronary artery bypass-grafting is
still one of the most important therapeutic strategy to treat it.
Chronic kidney disease is often affecting patients with CAD.
Nevertheless, the literature is still debating what formula estimate the
best the glomerular filtration rate in patients undergoing CABG. Indeed,
the formulas used in clinical practice have some differences some are
more accurate in patients with diabetes, while there are some bias given
by age and body mass index. In cardiac surgery, the choice of the most
fitting formula to evaluate GFR has important clinical implication and,
up to now, three formulas have been compared at most. Eilon Ram et al.
present a retrospective study which compares the 5 most used formulas
(CG, MDRD, CKD-EPI, Mayo, and IB) to derive GFR to evaluate the one with
the best accuracy in predicting long-term mortality. In order to do so,
they divided 3744 patients in three groups according to the estimated
GFR by means of all 5 formulas: significant CKD according to all
formulas, non-significant CKD according to all formulas and discordant
results (meaning that at least one formula gave normal GFR and at least
one formula gave abnormal GFR). Patients with the highest mortality were
the ones with significant CKD according to all formulas.