Intérêts et limites de l’estimation du débit de filtration glomérulaire avec des formules qui utilisent la créatinine ou la cystatine ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-07

AUTHORS

E. E. Fabre, A. Raynaud-Simon, J. -L. Golmard, N. Gourgouillon, J. -L. Beaudeux, V. Nivet-Antoine

ABSTRACT

La fonction rénale est altérée chez les sujets âgés. Un grand nombre de formules ont été proposées pour estimer la filtration glomérulaire afin d’ajuster la posologie des médicaments. La Haute Autorité de Santé recommande l’utilisation de la formule de Cockcroft et Gault corrigée par la surface corporelle mais l’équation de Cockcroft et Gault initialement décrite non ajustée à la surface corporelle est la formule principalement utilisée en milieu gériatrique. Les recommandations internationales proposent la formule du MDRD (Modification of Diet in Renal Disease) alors que d’autres auteurs recommandent d’utiliser dans des populations très particulières une formule utilisant la cystatine C, la formule de Rule. Afin d’estimer au plus juste le débit de filtration glomérulaire pour l’adaptation posologique des médicaments dans une population âgée polypathologique, une étude prospective a été entreprise à l’hôpital Charles Foix. Les concentrations plasmatiques de glucose, créatinine et les concentrations sériques de cystatine C, albumine, transthyrétine, de protéine C-réactive, d’orosomucoïde, de cholestérol total ont été déterminés chez 193 patients âgés de 70 ans et plus. Les résultats montrent que dans une population âgée, dénutrie et avec un syndrome inflammatoire, les formules de Cockcroft et Gault, MDRD et Rule conduisent à des estimations différentes du débit de filtration glomérulaire, estimations qui dépendent des paramètres nutritionnels et inflammatoires. Seule l’estimation de Cockcroft et Gault ajustée à la surface corporelle semble la plus juste et la mieux adaptée dans une population âgée polypathologique pour évaluer la fonction rénale afin d’adapter la posologie des médicaments. More... »

PAGES

26-30

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11834-010-0014-8

DOI

http://dx.doi.org/10.1007/s11834-010-0014-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1027219297


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