ArticleInternational journal of obesity (2005)2020
The estimation of GFR and the adjustment for BSA in overweight and obesity: a dreadful combination of two errors.
Article in International journal of obesity (2005), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers.
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Who cites it
48 citing papers in PubMed, 80 citations in OpenAlex.
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- Measurement, Estimation, and Correlates of the GFR before and after Bariatric Surgery.Journal of the American Society of Nephrology : JASN · 2026Article
- Enhancing eGFR cr-cys Accuracy in Extreme Body Mass Index Groups : Addressing Body Composition and Methodological Heterogeneity.Journal of the American Society of Nephrology : JASN · 2026Article
- Real-World Impact of Finerenone on Albuminuria in Patients with Diabetes and CKD.International journal of molecular sciences · 2025Article
- Obesity, Underweight, and Accuracy of eGFR Using Cystatin C and Creatinine in a Northern European Population.Journal of the American Society of Nephrology : JASN · 2025Article
- Impact of GFR on Mortality Risk After Biliopancreatic Diversion: Challenges and Pitfalls for the Clinician.Obesity surgery · 2025Article
- Causal effects of obesity on estimated glomerular filtration rate: a Mendelian randomization and image data analysis study.Clinical kidney journal · 2025Article
- New Obesity Guidelines and Implications for CKD.Kidney international reports · 2025Article
- The Role of miRNAs as Early Biomarkers in Obesity-Related Glomerulopathy: Implications for Early Detection and Treatment.Biomedicines · 2025Review
- Aligning kidney function assessment in patients with cancer to global practices in internal medicine.EClinicalMedicine · 2025Review
- Renal functional reserve in living kidney donors.Clinical kidney journal · 2025Article
- Obesity-Related Chronic Kidney Disease: From Diagnosis to Treatment.Diagnostics (Basel, Switzerland) · 2025Review
- Obesity-Related Kidney Disease in Bariatric Surgery Candidates.Obesity surgery · 2025Article
- Integrated miRNA-mRNA Analysis Reveals Critical miRNAs and Targets in Diet-Induced Obesity-Related Glomerulopathy.International journal of molecular sciences · 2024Article
- Cardiometabolic comorbidities and complications of obesity and chronic kidney disease (CKD).Journal of clinical & translational endocrinology · 2024Review
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18 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObesity is an established risk factor for renal disease and for disease progression. Therefore, an accurate determination of renal function is necessary in this population. Renal function is currently evaluated by estimated glomerular filtration rate (GFR) by formulas, a procedure with a proven high variability. Moreover, the adjustment of GFR by body surface area (BSA) confounds the evaluation of renal function. However, the error of using estimated GFR adjusted by BSA has not been properly evaluated in overweight and obese subjects.
methodsWe evaluated the error of 56 creatinine- and/or cystatin-C-based equations and the adjustment of GFR by BSA in 944 subjects with overweight or obesity with or without chronic kidney disease (CKD). The error between estimated (eGFR) and measured GFR (mGFR) was evaluated with statistics of agreement: the total deviation index (TDI), the concordance correlation coefficient (CCC) and the coverage probability (cp).
resultsThe error of eGFR by any equation was common and wide: TDI averaged 55%, meaning that 90% of estimations ranged from -55 to 55% of mGFR. CCC and cp averaged 0.8 and 26, respectively. This error was comparable between creatinine and cystatin-C-based formulas both in obese or overweight subjects. The error of eGFR was larger in formulas that included weight or height. The adjustment of mGFR or eGFR led to a relevant underestimation of renal function, reaching at least 10 mL/min in 25% of the cases.
conclusionsIn overweight and obese patients, formulas failed in reflecting real renal function. In addition, the adjustment for BSA led to a relevant underestimation of GFR. Both errors may have important clinical consequences. Thus, whenever possible, the use of a gold standard method to measure renal function is recommended. Moreover, the sense of indexing for BSA should be re-considered and probably abandoned.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.