ECE2016 Guided Posters Diabetes (2) (10 abstracts)
Calculated creatinine clearance using the CKD-EPI-formula shows a reliable prediction and high correlation to 24-h-urine in patients with diabetes mellitus but underrates systematically potentially leading to withdrawal or no prescription of oral antidiabetics
Christof Kloos , Nicolle Müller , Julia Anschütz , Friederike Klein , Katharina Burghardt , Sebastian Schmidt , Irina Schmidt , Klas Boer , Gunter Wolf & Ulrich Müller
University Hospital Jena, Jena, Thuringia, Germany.
Introduction: To reliably assess glomerular filtration is of vital importance if oral antidiabetics are used. We compared the CKD-EPI model, a clinically established calculation model to assess creatinine clearance (CreaClear) with specimens from 24-h urine.
Method: Inpatients (university hospital) with diabetes mellitus received a 24-h urine collection (24hClear) or since 2013 calculated CreaClear using CKD-EPI-formula (EPI). From 2014 to 2015 values of 615 simultaneously. Implausible 24-h-specimens (Creatinine excretion <8 or >22 mmol/24h) were excluded (n=268). Correlation (Cor) was calculated and mean values (MV) compared.
Results: Three hundred and forty-one persons were analyzed (n=120 diabetes type1 (DM1), n=285 type 2 (DM2), n=12 pancreas diabetes (DMpankr). Seventy-four (18%) had a 24hClear in the range from 40 to 60 ml/min (DM1 16%, DM2 81%, DMpankr 3%). Mean values and correlations were (EPI vs 24hClear ml/min, Cor (significance level), significance level T-test): whole group: 62.8 vs 75.1, Cor 0.88 (P<0.001), MV P<0.001; DM1: 82.1 vs 94.7 Cor 0.83 (P<0.001), MV P<0.001; DM2: 54.1 vs 66.0, Cor 0.87 (P<0.001), MV P<0.001; DMpankr 75.8 vs 97.1, Cor 0.85 (P<0.001), MV P<0.001. In 20% EPI was higher than 24hClear (DM1 27%; DM2 18%; DMpankr 0%). In regression analysis 24-h creatinine excretion is negatively associated with an overestimation of EPI (P<0,001).
Conclusions: Calculated values of creatinine clearance by the CKD-EPI-formula compared to values from 24-h urine collection from routine data were highly correlated. CKD-EPI produced lower values in 80% of the cases underrating in the range from 11(DM2) to 21(DMpancr) ml/min. This may lead to withdrawal or no prescription of oral antidiabetics, on the other hand preventing drug induced complications. The large difference of both methods in pancreas diabetes is caused by reduced muscle mass.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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