Detección temprana de la enfermedad renal crónica: una tarea conjunta entre médicos y bioquímicos

  • Silvia Fabiana Benozzi Universidad Nacional del Sur (Bahía Blanca, Argentina).
  • Graciela Laura Pennacchiotti Universidad Nacional del Sur (Bahía Blanca, Argentina).

Resumen

La detección temprana de la enfermedad renal crónica es prioritaria para prevenir la epidemia mundial de esta enfermedad con consecuencias devastadoras para el paciente y el sistema de salud. Los dos parámetros utilizados para su detección precoz requieren del trabajo conjunto entre médicos y bioquímicos, dado que, por un lado el médico debe hacer la adecuada solicitud del parámetro a evaluar y, por otro, el bioquímico debe asegurar la calidad de las mediciones que realiza. El índice de filtración glomerular estimado por fórmula está recomendado para la evaluación de la función renal, mientras que la detección de albuminuria es indiscutible como marcador precoz de daño renal. El objetivo principal de este trabajo es demostrar la necesidad del trabajo conjunto entre médicos y bioquímicos para efectuar un diagnóstico temprano de la enfermedad.

Biografía del autor/a

Silvia Fabiana Benozzi, Universidad Nacional del Sur (Bahía Blanca, Argentina).
Bioquímica. Especialista en Bioquímica Clínica. Magíster en Bioquímica. Cátedra de Bioquímica Clínica I, Universidad Nacional del Sur (Bahía Blanca, Argentina).
Graciela Laura Pennacchiotti, Universidad Nacional del Sur (Bahía Blanca, Argentina).
Bioquímica. Especialista en Bioquímica Clínica. Especialista en Gestión en Salud y Calidad en Bioquímica. Doctora en Bioquímica. Cátedra de Bioquímica Clínica I, Universidad Nacional del Sur (Bahía Blanca, Argentina). Hospital Municipal "Dr Leónidas Lucero"(Bahía Blanca, Argentina. 

Citas

Cusumano AR, Inserra F. Enfermedad renal crónica: necesidad de implementar programas para su detección. Revista de nefrología, diálisis y trasplante. 2007; 27(3):113-118.

Stevens P, Levin, A. Evaluation and Management of Chronic Kidney Disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2012 Clinical Practice Guideline. Ann Intern Med. 2013; 158:825-830.

Alemano G, Celia E, Cusmumano AM, Depine S, Greloni G, Inserra F et al. Guía de Prevención y Detección Precoz de Enfermedad Renal Crónica en Adultos en el Primer Nivel de Atención. Ministerio de Salud. Argentina. 2010.

Jha V, Garcia-Garcia G, IsekiK, Li Z, Naicker S, Plattner B, et al. Global Kidney Disease Chronic kidney disease: global dimension and perspectives. The Lancet 2013; 382: 260–72.

Shafi T, Coresh J. Chronic Kidney Disease: Definition, Epidemiology, Cost, and Outcomes Chronic Kidney Disease, Dialysis, and Transplantation. En Himmelfarb J, Sayegh MH Editores: Chandraker A, Mehrotra R,. O'Hare AM, Stivelman JC, Tuttle KR, Vella JP, Waikar SS. Chronic Kidney Disease Dialysis, and Transplantation. Capítulo 1. Tercera ed. Filadelfia 2010.p. 3-21.

Asociación Regional de Diálisis y Trasplantes Renales de Capital federal y Provincia de Buenos Aires [internet]. Buenos Aires.

Marinovich S, Lavorato C, Bisignano L, Soratti M, Hansen Krogh D, Celia E, et al. Registro Argentino de Diálisis Crónica 2013. Informe 2014. Instituto Nacional Central Único Coordinador de Ablación e Implante (INCUCAI), Sociedad Argentina de Nefrología.

Gutiérrez, R. Situación de la Insuficiencia Renal Crónica Terminal en el Municipio de Marcos Paz, Prov. de Bs. As. como base para una propuesta de detección precoz de la Enfermedad Renal Crónica. Rev. Nefrología, Diálisis y Trasplante. 2008; 28 (3):102-107.

Levey A and Coresh J. Chronic kidney disease. The Lancet 2012;379 (9811): 165 180.

James MT, Hemmelgam BR, Tonelli M. Early recognition and prevention of chronic kidney disease. The Lancet 2010;375:1296-1308.

Wetzels JFM,,Kiemeney LALM,, Swinkels DW, Willems HL and den Heijer M. Age- and gender-specific reference values of estimated GFR in Caucasians: The Nijmegen Biomedical Study. Kidney International.2007; 72: 632–637.

Moynihan R, Glassock R, Doust J. Chronic kidney disease controversy: how expanding definitions are unnecessarily labelling many people as diseased. BMJ 2013;347:f4298.

K/DOQI clinical practice guidelines for chronic kidney disease:evaluation, classification, and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis 2002; 39:S1-266.

Panteghini M. Myers GL, Miller WG, Greenberg N . La importancia de la trazabilidad metrológica en la validez de la medición de creatinina como índice de función renal. Acta Bioquím Clín Latinoam 2009; 43 (2): 271-7.

Rahn KH, Heidenreich S, Bruckner D. How to assess glomerular function and damage in humans. J Hypertens 1999; 17:309-17.

Miler M, Šimundić AM. Low level of adherence to instructions for 24-hour urine collection among hospital outpatients. Biochem Med 2013;23:316-20.

Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003; 139:137-47. [Erratum, Ann Intern Med 2003; 139:605].

Siegel NJ. Renal Express. Journal of the American Society of Nephrology [internet]). 2003.

National Kidney Disease Education Program. Laboratory professionals: Creatinine Standardization Program.

Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67: 2089-100.

State of New Jersey, 211th Legislature. Senatebill no. 2232. January 24, 2005.

Mathew TH. Australasian Creatinine Consensus Working Group. Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: a position statement. Med J Aust 2005; 183: 138-41.

La Caisse nationale d'assurance maladie des professions indépendantes: avenant à la convention nationale des directeurs de laboratoire privé d'analyses médicales.

British Columbia Ministry of Health, Guidelines & Protocols Advisory Committee. Identification, evaluation and management of patients with chronic kidney disease.

Cockcroft, DW and Gault, MH .Predicition of creatinine clearance from Serum creatinine. Nephron 1976; 16:31-41.

Michels WM, Grootendorst DC, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and New CKD-EPI Formulas in Relation to GFR, Age, and Body Size. Clin J Am Soc Nephrol. 2010; 5(6): 1003–1009.

Stevens LA, Coresh J, Feldman HI, et al. Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol 2007; 18: 2749–57.

Levey A., Bosch JP; Breyer Lewis J, Greene T, Rogers N, Roth D .A more accurate method to estimate glomerular flitration rate from serum creatinine: a new prediction equation. Annals of Internal Medicine 1999; 130: 461-70.

Alles A, Fraga A, García T, Gómez A, Greloni G, Inserra F. Documento Multidisciplinario: Detección precoz de Enfermedad Renal Crónica. Acta Bioquím Clín Latinoam 2010; 44 (3): 377-84.

Stevens L, Coresh J, Greene T, Levey A. Assessing kidney function – Measured and estimated glomerular filtration rate. N Engl J Med 2006; 354: 2473-83.

National Kidney Disease Education Program .Estimating GFR. MDRD Study Equation.

Levey AS, Stevens LA, Schmid CH, et al, for the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150: 604–12.

Levey AS, Stevens LA. Estimating GFR using the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation: more accurate GFR estimates, lower CKD prevalence estimates, and better risk predictions. Am J Kidney Dis 2010; 55: 622–27.

Stevens LA, Schmid CH, Greene T, Zhang YL, Beck GJ, Froissart M, et al. Comparative performance of the CKD Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) Study equations for estimating GFR levels above 60 mL/min/1•73 m2. Am J Kidney Dis 2010; 56: 486–95.

Martínez-Castelao A, Górriz JL, Bover J, Segura-de la Morena J, Cebollada J, Escalada J, et al. Documento de consenso para la detección y manejo de la enfermedad renal crónica. Nefrologia 2014;34(2):243-62

National Kidney Foundation.

Schaeffner L, Ebert N, Delanaye P, Frei U, Gaedeke J, Jakob O, et al. Two Novel Equations to Estimate Kidney Function in Persons Aged 70 Years or Older. Ann Intern Med. 2012;157:471-481.

Inker L, Schmid, CH, Tighiouart H, Eckfeldt JH, Feldman HI, Greene T, et al. Estimating Glomerular Filtration Ratefrom Serum Creatinine and Cystatin C. N Engl J Med 2012;367:20-9.

Schwartz GJ, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009; 20: 629-637.

Schwartz GJ and Work DF. Measurement and estimation of GFR in children and adolescents. Clin J Am Soc Nephrol. 2009; 4(11): 1832-43.

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl 2013;3:1-150 2013. National Kidney Disease Education Program. Considerations for Pediatric Patients. [Citado 7 Feb 2013]. Disponible en: http://nkdep.nih.gov/identify-manage/pediatricpatients.shtml

Johnson DW, Jones GR, Mathew TH, Ludlow MJ, Doogue MP, Jose MD et al. Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: new developments and revised recommendations. Med J Aust 2012;197:224-5.

Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20:629-37.

Filler G, Bokenkamp A, Hofmann W, Le BT, Martinez-Bru C, Grubb A. Cystatin C as a marker of GFR--history, indications, and future research. Clin Biochem 2005;38:1-8.

Tangri N, Stevens LA, Schmid CH, Zhang YL, Beck GJ, Greene T, et al. Changes in dietary protein intake has no effect on serum cystatin C levels independent of the glomerular filtration rate. Kidney Int 2011;79:471-4.

Stevens LA, Schmid CH, Greene T, Li L, Beck GJ, Joffe MM, et al. Factors other than glomerular filtration rate affect serum cystatin C levels. Kidney Int 2009;75:652-60.

Knight EL, Verhave JC, Spiegelman D, Hillege HL, de ZD, Curhan GC, de Jong PE. Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney Int 2004;65:1416-21.

Andersen TB, Eskild-Jensen A, Frokiaer J, Brochner-Mortensen J. Measuring glomerular filtration rate in children; can cystatin C replace established methods? A review. Pediatr Nephrol 2009;24:929-41.

Bacchetta J, Cochat P, Rognant N, Ranchin B, Hadj-Aissa A, Dubourg L. Which creatinine and cystatin C equations can be reliably used in children? Clin J Am Soc Nephrol 2011;6:552-60.

Groesbeck D, Kottgen A, Parekh R, Selvin E, Schwartz GJ, Coresh J, Furth S. Age, gender, and race effects on cystatin C levels in US adolescents. Clin J Am Soc Nephrol 2008;3:1777-85.

American Diabetes Association. Nephropathy in Diabetes. Diabetes Care 2004; 27 (Suppl 1): S79-S83.

Khosla N, Sarafidis Pa, Bakris Gl. Microalbuminuria. Clin Lab Med 2006; 26: 635-53.

National Institute for Health and Clinical Excellence. Chronic Kidney Disease: National Clinical Guideline for Early Identification and Management in Adults in Primary and Secundary Care. Clinical Guideline 73 [Internet], 2008; [consultado el 15-6-2010]. Disponible en: http://www.nice.org.uk/Guidance/cg73

Joint Specialty Committee on Renal Medicine of the Royal College of Physicians and the Renal Association, and the Royal College of General Practitioners. Chronic Kidney Disease in Adults: UK Guidelines for Identification, Management and Referral. London: Royal College of Physicians [Internet], 2006; [consultado el 15-6-2010]. Disponible en: http://www.renal.org/CKDguide/full/CKDprintedfullguide.pdf.

Caring for Australasians with Renal Impairment (CARI). Chronic Kidney Disease Guidelines: Urine Protein as Diagnostic Test [Internet], 2004; [consultado el 15-6-2010]. Disponible en: http://www.cari.org.au/ckd_urineprot_list_pub2004.php.

Montañés Bermúdez S, García G, Pérez Surribas D, Martínez Castelao A, Bover Sanjuán J. Documento de Consenso. Recomendaciones sobre la valoración de la proteinuria en el diagnóstico y seguimiento de la enfermedad renal crónica Nefrologia 2011;31(3):331-45.

Eknoyan G, Hostetter T, Bakris GL, Hebert L, Levey AS, Parving HH , et al. Proteinuria and other markers of chronic kidney disease: a position statement of the national kidney foundation (NKF) and the national institute of diabetes and digestive and kidney diseases (NIDDK). Am J Kidney Dis 2003; 42: 617–22.

Miller WG, Bruns DE, Hortin GL, Sandberg S, Aakre KM, McQueen MJ, et al. for the National Kidney Disease Education Program-IFCC Working Group on Standardization of Albumin in Urine. Current issues in measurement and reporting of urinary albumin excretion. Clin Chem2009; 55: 24–38.

Inserra, F; Angerosa, M; Alegre, J.; Alles, A., Bianchi, ME; Dorado, E et al. Documento De Consenso: Implicancia de la Proteinuria en el Diagnóstico y Seguimiento de la Enfermedad Renal Crónica Acta Bioquím Clín Latinoam 2013; 47 (3): 613-25.

Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, Gansevoort RT, Kasiske BL, Eckardt KU. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011; 80: 17-28.

Sacks DB. The National Academy Of Clinical Biochemistry. Guías de práctica del laboratorio clínico. Guías y recomendaciones para el diagnóstico y manejo de la diabetes mellitus. Acta Bioquím Clín Latinoam 2012; 46(4): 701-41.

Abdelmalek JA, Gansevoort RT, LambersHeerspink HJ, Ix JH, Rifkin DE. Estimated albumin excretion rate versus urine albumin-creatinine ratio for the assessment of albuminuria: a diagnostic test study from the Prevention of Renal and Vascular Endstage Disease (PREVEND) Study. Am J Kidney Dis. 2014;63(3):415-21.

Fotheringham J, Campbell MJ, Fogarty DG, El Nahas M, Ellam T. Estimated albumin excretion rate versus urine albumin-creatinine ratio for the estimation of measured albumin excretion rate: derivation and validation of an estimated albumin excretion rate equation. Am J Kidney Dis. 2014;63(3):405-14.

Saydah SH, Pavkov ME, Zhang C, Lacher DA, Eberhardt MS, Rios Burrows N, et al. Albuminuria Prevalence in First Morning Void Compared with Previous Random Urine from Adults in the National Health and Nutrition Examination Survey, 2009–2010 Clinical Chemistry 2013;59:4 675-683.

PAIERC INCUCAI. Programa de abordaje Integral de la Enfermedad Renal Crónica.

Publicado
2018-01-27
Sección
Artículo original