Abstract: FR-PO110

Using the Kinetic eGFR (KeGFR) Formula for Estimating GFR and Detecting AKI: A Pilot Study

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Bairy, Manohar, TTSH Singapore, Singapore, Singapore
  • See, Faith Huiwen, Yong Loo Lin School of Medicine, Singapore, Singapore
  • Lim, Ru Sin, TTSH Singapore, Singapore, Singapore
Background

Estimating GFR when the Creatinine(Cr) is rapidly changing as in AKI has been a challenge. The KeGFR formula by S.Chen estimates GFR by factoring in the time interval between rising Cr values and the Volume of distribution(Vd). It has the added advantage of providing the clinician with a eGFR value for each non steady state Cr value.We employed the KeGFR formula to detect AKI in an adult non ICU inpatient setting.We then compared KeGFR with the current standard (AKIN and RIFLE)and newer criteria( Waikar-Bonventre,Delta Check) for AKI detection.

Methods

250 consecutive adult patients admitted to the Medical wards were screened. Patients with a change in Cr of >4.3 %( Biological Variation) were included in the study(n=80). The KeGFR formula was applied to this cohort after calculating the Vd individually after estimating the initial GFR by MDRD. A fall in eGFR of 25% or more was considered as AKI. The AKIN, Waikar-Bonventre,RIFLE and Delta Check criterion were also applied to this cohort and compared with the KeGFR criterion.

Results

Forty nine patients had AKI by AKIN classification. All but one patient (30) found to have AKI by KeGFR criterion fulfilled the AKI definition by AKIN(Table 1). AKIN diagnosed an additional 19 patients to have AKI. However, all of these had an elevated creatinine level on admission hence requiring the incorporation of baseline creatinine(BCr) by AKIN which is not part of the KeGFR formula. Moreover, the latest Cr value in the preceeding 3 months was assumed to be the BCr . 5 of these 19 patients were deemed not to have AKI by clinical adjudication. All patients with in-hospital AKI and progressive AKIwere detected by both the criteria.

Conclusion

The KeGFR formula can be readily applied to estimate GFR in the non-steady state. A KeGFR based criterion successfully detected progressive and in hospital AKI in this study.