Introduction: Impaired renal function is an independent risk factor for cardiac events. For its evaluation is recommended to calculate glomerular filtration (GF) using Cockcroft-Gault formula. In ambulatory praxis is calculation of GF often underestimated, especially in patients with creatinine level in reference range.
Method: We compared meaning of calculated GF and quartiles of creatinine (Q-CREA) in reference range (≤ 135 μmol/l) on consideration of classic risk factors and absolute risk in pts with arterial hypertension (AH).
Results: In multicentric project were enrolled 558 out-ward pts (M-39.2%; F-60.8%) with AH (162.9±17.4/94.3±8.8 mm Hg) with CREA≤ 135 μmol/l. Calculated GF identified only 56.8% of pts in 1.grade, 33.9% were in 2. grade, res. 8.1% in 3. grade of renal impairement (K/DOQI). Pts in 3.grade of K/DOQI exhibited significantly higher absolute risk (acc. to SCORE) in comparison with 4Q-CREA : 6.20 vs. 6.08 (p<0.05). K/DOQI distribution shown higher statistical between-subjects contrasts of classic risk factors in comparison with Q-CREA distribution (Tabs 1 and 2).
Table1. Distribution of classic risk factors acc. to Q-CREA
Age SBP/ DBP LDL HDL TG
Q-CREA [yrs] [mmHg] [mmol/l] [mmol/l] [mmol/l]
1 62.5 161.2/ 92.1 3.29 1.40 1.95
2 61.8 163.6/ 94.6 3.31 1.39 2.10
3 61.7 163.1/ 95.8 3.34 1.33 2.35
4 61.7 163.5/ 94.9 3.44 1.34 2.23
Signif NS NS 0.02 NS NS 0.001
Table 2. Distribution of classic risk factors acc. to K/DOQI.
Age SBP/ DBP LDL HDL TG
K/DOQI [yrs] [mmHg] [mmol/l] [mmol/l] [mmol/l]
1 57.1 161.9/ 95.0 3.34 1.33 2.21
2 66.9 163.6/ 93.4 3.44 1.43 2.13
3 75.3 168.0/ 94.0 3.13 1.39 1.92
Signif 0.001 0.03 0.04 0.08 - NS 0.02 NS
Conclusion: Use of Cockroft-Gault formula in stratification of out-ward patients with arterial hypertension provide more relevant clinical information in comparison with consideration of creatinine in reference range.