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Detection of renal failure in overweight patients.

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Deadline for receipt of abstracts: 01-02-2004

Name and address of corresponding author Name: Delanaye Pierre      

Institute: CHU Sart Tilman       Address: Service de Dialyse B35      Post code: 4000     

City: LIEGE    

Telephone: 043667111      fax: 043667205      e-mail: pierre_delanaye@yahoo.fr      First author age < 35 years (born in 1969 or later): yes - no (please underline)

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ABSTRACT FORM

Annual Scientific Meeting of the BVN/SBN, Liège, 1 April 2004

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TITLE: DETECTION OF RENAL FAILURE IN OVERWEIGHT PATIENTS

Authors: Delanaye P, Radermecker RP, Rorive M, Depas G, Chapelle JP, Gielen J, Krzesinski JM. Affiliation: CHU Sart Tilman, Liège.

Chronic renal failure is a frequent complication in obesity. Detection of renal failure is thus important in this population. The goal of this study is to compare serum creatinine with serum cystatin C in their ability to detect GFR under 60 ml/min/1.73 m2.

Patients with body mass index (BMI) over 27 kg/m2 were included. The reference method for GFR

measurement was Cr 51-EDTA (single injection method). GFR measured by Cr 51-EDTA was corrected by body surface area, calculated with the formula specifically developed for obese patients by Livingston. Serum creatinine was measured by compensated Jaffé method and cystatin C by particle-enhanced

nephelometric immunoassay method.

The population included 39 patients, 9 males and 30 women. Their mean age was 47.5 ± 11.5 years and their mean BMI was 39.3 ± 6.5 kg/m2. Seventeen patients had BMI over 40 kg/m2. The mean GFR

measured by Cr 51-EDTA was 78.4 ± 18 ml/min/1.73m2 (20 patients with GFR under 80 ml/min/1.73m2

and 7 patients with a GFR under 60 ml/min/1.73m2). Correlation between the reciprocal of creatinine and

GFR (r=0.31) is not significant (p=0.054) although correlation between the reciprocal of cystatin C and GFR (r=0.49) is statistically significant (p=0.0015). This difference between correlations is particularly high when the 17 patients with BMI over 40 kg/m2 are only considered (r=0.53 for cystatin versus r=-0.08

for creatinine). By ROC curves, sensitivity and specificity of both markers to detect GFR under 60 ml/min/1.73 m2 were analysed. For creatinine, area under the curve is not statistically different from ½

(AUC=0.65, p=0.24) although AUC for cystatin C is different from ½ (AUC=0.82, p=0.002).

Serum cystatin C appears thus better than serum creatinine to detect GFR under 60 ml/min/1.73 m2 in our

population of overweight patients. This new plasma marker seems particularly appropriate in case of severe obesity (BMI > 40 kg/m2). These preliminary results must yet be confirmed in a larger population.

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