Banca de QUALIFICAÇÃO: ANA CAROLINA ABREU MACHADO

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : ANA CAROLINA ABREU MACHADO
DATE: 25/07/2023
TIME: 09:00
LOCAL: famed
TITLE:

EVALUATION OF THE BERLIN INITIATIVE STUDY (BIS 1) EQUATION TO ESTIMATE GLOMERULAR FILTRATION RATE IN THE ELDERLY

KEY WORDS:

Evaluation. Aging. Renal System.

PAGES: 35
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Aging is a universal biological phenomenon where individuals and their
organs age at varying rates, influenced by genetic coding and
environmental factors. The renal system is also affected by this process, presenting
anatomical, histological, and hemodynamic changes that ultimately lead to
a reduction considered "physiological" in glomerular filtration rate (GFR).
(GLASSOCK, 2016). In clinical practice, correctly measuring GFR is extreme
Importance for the proper classification and follow-up of individuals with
or not, of chronic kidney disease, aiding in the reduction of complications, as well as in the
correction of drug doses and in making decisions regarding the need for
drug therapies, invasive or contrasted procedures. (SCHAEFFNER et
al., 2012; FERNANDES, et al., 2015). GFR measurement can ideally be done
by determining the renal clearance of some exogenous substances, such as:
inulin, iohexol or a radiolabelled molecule (e.g. EDTA). However, these measures
are invasive, complex to perform and expensive and are rarely used in the
daily clinical practice. Thus, the measurement of the estimated GFR ends up being more
frequent through the clearance of creatinine in the urine collected within 24 hours.
(PÉQUIGNOT et al., 2009). The choice of creatinine for this purpose is due to the fact
to be produced in the skeletal musculature and to be almost entirely excreted via the kidney,
having a very low rate of tubular secretion and resorption. This is one more option
feasible, however, in the elderly, the use of urinary creatinine brings a series of
particularities that end up interfering with the applicability of this measure. One of the
main is the difficulty in collecting 24-hour urine due to issues related to
urinary incontinence, dementia or even immobility, common in this
population. (PÉQUIGNOT et al., 2009) Being then in the vast majority of cases,
serum creatinine was used through pre-established and validated formulas for
achieve this end. In the elderly, the high prevalence of sarcopenia is low
protein consumption, especially in the most fragile, leads to a reduction in levels
serum creatinine, which may remain normal even in the elderly with
reduced renal function. This change in the creatinine/creatinine clearance ratio
(where creatinine remains constant while clearance tends to decrease) ends
for generating a challenge when the goal is to reliably measure GFR in the
elderly population. (ABREU et al., 1998). The most commonly used formula is that of

Cockroft-Gault (CG) of 1976, where creatinine clearance ml/min = [ (140-age in
years) x weight in kg / 72 x serum creatinine mg/dl] x 0.85 if female. (PÉQUIGNOT et
al. 2009). In the last 15 years, new formulas for estimating GFR have been
developed, including the best known as the Modification of Diet in Renal
Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI).
However, its use is still limited in the elderly due to the lack of representativeness
of this population in the validation studies, and most of them excluded the individuals
over 70 years. (LENGNAN et al., 2021; XIA, F. et al., 2021). In this context, the
Berlin Initiative Study has developed a new formula based on creatinine, sex and
age (BIS 1), in a study where only individuals over 70 were included
years. (SCHAEFFNER et al., 2012). The aim of the present study is to evaluate the
diagnostic performance of the BIS 1 equation and compare its agreement
tool with the most used currently within our population, analyzing the
possible variables related to the differences found, so that we can have
a more reliable, low-cost, and easy-to-manage option for measuring renal function
in elderly patients and serve as a basis for future validation studies with our
population.

BANKING MEMBERS:
Presidente - 2370894 - MICHELLE JACINTHA CAVALCANTE OLIVEIRA
Interno(a) - 3621153 - JULIANA CELIA DE FARIAS SANTOS
Interno(a) - 7530212 - MERCIA LAMENHA MEDEIROS
Externo(a) ao Programa - 2121182 - ANDRE FALCAO PEDROSA COSTA