Cystatin C measurement leads to lower metformin dosage in elderly type 2 diabetic patients
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61988987%3A17110%2F19%3AA2002488" target="_blank" >RIV/61988987:17110/19:A2002488 - isvavai.cz</a>
Alternative codes found
RIV/27661989:_____/19:N0000001
Result on the web
<a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.13132" target="_blank" >https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.13132</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1111/bcpt.13132" target="_blank" >10.1111/bcpt.13132</a>
Alternative languages
Result language
angličtina
Original language name
Cystatin C measurement leads to lower metformin dosage in elderly type 2 diabetic patients
Original language description
The aim of this study was to provide evidence for the hypothesis that estimated glomerular filtration rate from serum Cystatin C (eGFRcys) is better to be determined for all elderly type 2 diabetes mellitus (T2DM) patients based on eGFRcys upward and downward reclassification rate for hypothetical metformin dose reduction by eGFRcys at the GFR decision point of 45 mL/min/1.73 m(2). A total of 265 consecutive T2DM elderly patients (age range 65-91 years) from outpatient diabetic clinic were included in the study. The Kidney Disease Improving Global Outcomes (KDIGO) guidelines for metformin dosing were strictly followed. Estimated glomerular filtration rate from serum creatinine (eGFRcrea) led to results of metformin eligibility. Each of the results of eGFRcrea-based eligibility was further compared to eGFRcys-based eligibility. Creatinine was measured by enzymatic method standardized against international reference material SRM 967. Cystatin C was determined by method traceable to DA ERM 471 international standard. eGFRcrea and eGFRcys were calculated according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. A downward reclassification rate was higher than upward reclassification rate (31 vs 3, respectively; P < 0.0001). The median (IQR) eGFRcrea was higher than eGFRcys (73 (58-85) vs 63 (50-75) mL/min/1.73 m(2), respectively; P < 0.0001). eGFRcys reclassified significant proportion of patients with T2DM from metformin eligible CKD stages to less or non-eligible stages. The downward reclassification was more frequent in patients older than 80 years (P < 0.01). Cystatin C-based eGFR selects more complicated patients, where lower doses of metformin are possibly advisable. We recommend calculating both eGFRcrea and eGFRcys for metformin dosing in elderly patients with T2DM.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30104 - Pharmacology and pharmacy
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2019
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY
ISSN
1742-7835
e-ISSN
1742-7843
Volume of the periodical
124
Issue of the periodical within the volume
3
Country of publishing house
US - UNITED STATES
Number of pages
4
Pages from-to
298-302
UT code for WoS article
000458435400009
EID of the result in the Scopus database
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