Variability in creatinine excretion in adult diabetic, overweight men and women: consequences on creatinine-based classification of renal disease

Diabetes Research and Clinical Practice
David JacobiFrançois Maillot

Abstract

It is crucial to estimate renal function in diabetic patients. However, formulas are inadequate in this population whereas creatinine clearance (C(cr)) on a 24-h urine collection may be valuable only if we can improve its reproducibility. To evaluate in diabetic patients whether standardised procedures of 24-h urine collection improve the day-to-day variability in creatinine urinary excretion and the subsequent precision of the measured C(cr). The C(cr) from two consecutive 24-h urine collections was measured in 201 consecutive diabetic inpatients. Procedures of 24-h urine collection were standardised, and implementation was supervised at a diabetes clinic. Pearson's correlation coefficients of the two 24-h creatinine urinary excretion were significant (r(2)=0.64 in women and r(2)=0.65 in men, p<0.0001) but the daily variability in creatinine urinary excretion was high (14.9% in women and 17.4% in men). As a consequence, the agreement between the two consecutive measurements of C(cr) was poor. First, Bland-Altman plots showed large 95% limits of agreement (-34.3 to 34.6 mL/min/1.73 m(2) in women and -39.0 to 52.0 mL/min/1.73 m(2) in men). Secondly, there was a poor agreement for classifying patients according to the National Ki...Continue Reading

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Citations

Jun 18, 2011·Diabetes & Metabolism·V RigalleauH Gin
Oct 26, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Kambiz Kalantari, W Kline Bolton

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