T.O. Pertseva, M.K. Rokutova

Evaluation of different methods for calculating gfr in patients with abdominal obesity

In the article the results of GFR estimation in patients with abdominal obesity are presented, calculated on the Reberg-Tareev test with/without an amendment on the area of body surface, and also on the estimation formulas of Cockcroft-Gault with/without an amendment on the area of body surface, MDRD and CKD-EPI. 61 patients are inspected from age 18 by 40 years (mean age - 28,0±1,0 years) with abdominal obesity, I-III (in obedience to classification of IDF, 2005). It is shown that for the patients with abdominal obesity estimation formulas (Cockcroft-Gault with amend on the area of body surface, MDRD and CKD-EPI) and also Reberg-Tareev test with amendment on the area of body surface understate the indexes of GFR and mask patients with glomerular hyperfiltration.

Analysis of the data showed the highest value of sensitivity, specificity and area under the curve in assessing GFR by Reberg-Tareev test and formula Cockroft-Gault without adjustment for body surface area in comparison with other methods of investigation GFR in patients with abdominal obesity. The average values of sensitivity and area under the curve found in the calculation of eGFR using the formula Cockroft-Gault and Reberga-Tareev test adjusted for body surface area, but the specificity of these tests is much lower. Thus, the effectiveness of these methods for calculating GFR is significantly reduced in patients with abdominal obesity. The lowest values of similar parameters observed in the calculation of eGFR using MDRD and CKD-EPI formulas, indicating that the low information content of these formulas to calculate GFR in these patients.

Taking into account the limited reliability of formulas for the GFR estimation in the persons with abdominal obesity and initial displays of chronic kidney disease it is better to use the Reberg-Tareev test or Cockcroft-Gault formula without an amendment on the area of body surface.