Estimation of Glomerular Filtration Rate in Adults with Common Variable Immunodeficiency Treated with Intravenous Immunoglobulin. What formula should we use?

Abstract

Background: The common variable immunodeficiency (CVID) is characterized by absence of isohemagglutinins and two standard deviations of normal levels of immunoglobulins. His treatment includes administering immunoglobulin, more frequently intravenous (IVIG). A side effect is the possible severe renal insuf ciency secondary to the use of preparations containing sucrose. These patients have weight loss, decreased muscle mass associated with gastrointestinal disorders and bronchiectasis that limit physical activity and other factors. There are different formulas for determining the glomerular ltration rate, we compared the most commonly used to determine the most appropriate in this population. Objective: To determine the correlation between glomerular ltration rate using the MDRD formula, CKD-EPI and Cockcroft-Gault and that obtained through the urine creatinine clearance 24 h in patients with common variable immunode ciency who are treated with IVIG. Patients and method: A transversal, observational and descriptive study that included 19 patients with common variable immunode ciency, 12 women and 7 men, mean age 36 years, was done. Descriptive statistics with mean, median, mode and standard deviation was used. To measure the concordance of the measurements for quantitative variables intra- class correlation coef cient was used and to determine the correlation between the stages of renal function with different formulas kappa index was calculated. Results: The values of the intraclass correlation coef cient showed a good correlation between creatinine clearance in 24 h urine with CKD-EPI, mediocre with MDRD and nil with the Cockroft-Gault formula. Conclusions: Glomerular ltration rate obtained with CKD-EPI proved to be partially most useful, with a good correlation in relation to urine creatinine clearance in 24 h. Its routine use is recommended over other formulas in common variable immunodeficiency patients with suspected renal disease secondary to the use of IVIG.

Keywords

• inmunodeficiencia común variable
• tasa de filtración glomerular
• inmunoglobulina intravenosa.