Serum creatinine and estimated glomerular filtration rate (eGFR), determined using
the Modification of Diet Renal Disease (MDRD)-4, the MDRD-6 or the Chronic Kidney
Disease Epidemiology Collaboration (CKD-EPI) equations, substantially overestimate
kidney function in patients with liver cirrhosis [
[1]
]. By directly measuring GFR, Kalafateli et al. developed an alternative eGFR formula,
the Royal Free Hospital (RFH) cirrhosis GFR, that more accurately estimates GFR in
cirrhotic patients [
[2]
]. The tight correlation between measured GFR and RFH cirrhosis GFR was later confirmed
by Pedersen et al. [
[3]
] By reversely applying commonly used eGFR formulae to measured GFR, Kalafateli et
al. derived “corrected creatinine” values that were used to calculate “corrected Model
for End-Stage Liver Disease (MELD)” scores [
[2]
]. Median “corrected MELD” was 3 points higher than conventional MELD, and this could
impact patient allocation for liver transplantation. However, superiority of “corrected”
over conventional MELD as prognostic index in cirrhosis has yet to be demonstrated.To read this article in full you will need to make a payment
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References
- Review article: renal function assessment in cirrhosis—difficulties and alternative measurements.Aliment Pharmacol Ther. 2007; 26: 969-978https://doi.org/10.1111/j.1365-2036.2007.03443.x
- Development and validation of a mathematical equation to estimate glomerular filtration rate in cirrhosis: the royal free hospital cirrhosis glomerular filtration rate.Hepatology. 2017; 65: 582-591https://doi.org/10.1002/hep.28891
- The royal free hospital cirrhosis glomerular filtration rate: validation in a Danish cohort.Hepatology. 2017; 66: 1360-1361https://doi.org/10.1002/hep.29386
- Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry.Intern Emerg Med. 2016; 11: 1059-1066https://doi.org/10.1007/s11739-016-1416-8
- A model to predict survival in patients with end-stage liver disease.Hepatology. 2001; 33: 464-470https://doi.org/10.1053/jhep.2001.22172
- Advanced liver disease study group. The model for end-stage liver disease (MELD).Hepatology. 2007; 45: 797-805https://doi.org/10.1002/hep.21563
- Hyponatremia and mortality among patients on the liver-transplant waiting list.N Engl J Med. 2008; 359: 1018-1026https://doi.org/10.1056/NEJMoa0801209
- A new look at the statistical model identification.IEEE Trans Autom Control. 1974; 19 (MR 0423716): 716-723https://doi.org/10.1109/TAC.1974.1100705
Article info
Publication history
Published online: December 16, 2017
Accepted:
December 14,
2017
Received:
December 1,
2017
Footnotes
☆The Authors have no conflicts of interest to declare.
☆☆This work was supported by research funding from Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Identification
Copyright
© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
