Renal Function Assessment in the Elderly Using Plasma Creatinine Assay and Lean Body Mass Measurement

  • STATUS
    Recruiting
  • End date
    Nov 2, 2022
  • participants needed
    220
  • sponsor
    University Hospital, Strasbourg, France
Updated on 24 June 2021

Summary

Glomerular filtration rate (GFR) is the recommended parameter to assess renal function. The reference technique to measure GFR (clearance of a glomerular agent) is not commonly used. Instead, estimations (eGFR) are routinely taken from serum creatinine (SCr) with several published formulae: Cockcroft and Gault, MDRD, CKD-EPI. Basically, all these formulae aim at predicting the endogenous creatinine production by morphological parameters (age, body weight...) However, in the elderly, muscular mass is extremely variable and sarcopenia is quite commonly encountered (frequently linked to Alzheimer disease). This is probably the main reason why the aforementioned formulae are not valid in this population: for a given renal function, a lower muscular mass induces a lower creatinine production and, henceforth, a lower SCr value, which gives an overestimation of eGFR.

Muscular mass is closely linked to lean body mass (LBM), which can be properly assessed by whole-body dual X-ray absorptiometry (DXA). Alternatively, Bioelectric Impedance Spectroscopy (BIS) can also be used.

Investigators postulate that it is possible to estimate GFR in the elderly from both SCr and LBM estimation from DXA. Proof of concept has already been made by others but until now, no specific formula for the elderly has been devised and properly validated.

Investigators'aim is thus to propose a new formula to predict GFR from both SCr and LBM (estimated from DXA) in the elderly. This formula will be elaborated from a first series of 100 patients and validated on a second series of 100 other patients.

Details
Condition Renal function test, Renal Function, kidney function tests, renal function tests, renal function study, kidney function test
Treatment measurement of morphological parameters, a blood sample, albumin or blood in urine, Dual X-ray absorptiometry (DXA), Bioelectric Impedance Spectroscopy (BIS), 51Cr-EDTA plasma clearance
Clinical Study IdentifierNCT02288663
SponsorUniversity Hospital, Strasbourg, France
Last Modified on24 June 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

age of 75 years of more
origin from Western Europe or North Africa
covered by social health insurance
general health condition allowing transportation and ambulatory procedures during one day

Exclusion Criteria

ascitis, oedema or third compartment
fast change in body weight (more than 5% in less than one week)
eGFR < 30 mL/min/1.73 m (using MDRD formula)
legal concerns: prisoners, guardianship, lack of health insurance, failure to consent
intake of drugs that interfere with creatinine tubular secretion
cimetidine
trimethoprim
intake of drugs that interfere with creatinine assay
calcium dobesilate
hydroxocobalamin
N-ethylglycine
phenindione
lidocaine
inability to lie during 10 minutes without moving
patients who are bedridden, hemiplegic or highly dependent on others
any health condition that, in the investigator's opinion, could rapidly (< 1 week) vary the extracellular volume or GFR (these is voluntarily left open to the investigator because it is hardly possible to make an exhaustive list here)
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