Utility of chronic kidney disease epidemiology collaboration (ckd-epi) equations in obese diabetic individuals before and after weight loss

摘要

Obese individuals with type 2 diabetes with albuminuria can have normal or elevated (hyperfiltration) glomeralar filtration rates (GFRs).1 In this group, traditional creatinine-based GFR estimating equations fare badly compared to measured GFR (mGFR) using gold-standard radioisotope methods.2 Their higher fat-free mass can increase creatinine production compared with lighter individuals with the same mGFR. Following weight loss, the utility of eGFR equations to determine changes in mGFR is unclear in the presence of altered body composition and loss of lean mass. Moreover, in the obese, the pitfalls of indexing GFR to a body surface area (BSA) of 1.73 m2 are well known.