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Glomerular filtration rate assessed by using creatinine and cystatin in patients treated with dabigatran

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La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine

Summary

Background

Dabigatran (DAB) is 80 % renally excreted. Glomerular filtration rate (GFR) estimation is recommended to evaluate the kidney function for DAB dosage adjusting. In this paper we report same results about evaluation of creatinine (CRE) GFR and cystatin-C (CYS) GFR in comparison with drug concentration in a group of patients treated with DAB.

Methods

We considered 77 patients in which an evaluation of kidney function using CRE and CYS based GFR was performed. After GFR-CRE and GFR-CYS calculation these patients were classified as recommended by KDIGO guidelines. Moreover we evaluated the relationship between trough DAB concentration and GFR-CRE or GFR-CYS.

Results

We observed a satisfactory correlation between GFR-CRE and GFR-CYS (\(R=0.85\)). Following KDIGO criteria, patients’ classification performed by using GFR-CRE or GFR-CYS was concordant in 52 (68 %) subjects and discordant in 25 (32 %). We observed an inverse relationship between trough DAB concentration versus GFR-CRE (\(R=-0.71\)) and GFR-CYS (\(R=-0.79\)).

Conclusions

Results obtained in this study, although preliminary, suggested that, in this particular subset of patients, the determination of GFR-CYS can be a better renal function indicator than GFR-CRE. Moreover, we observed that GFR evaluation alone is not able to explain in a satisfactory manner, individual responses to dabigatran etexilate evaluated as a trough DAB concentration.

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Acknowledgements

We are grateful to the following technicians of our Laboratory: L. Penzo, F. Giusto and E. Speranza for the execution of laboratory tests. Moreover we wish thanks Dr. P. Bellati (EMEA Marketing Director Tosoh Bioscience) and Dr. A. Pacioni (Scientific Affair Dasit) for technical assistance and helpful discussion.

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Authors and Affiliations

  1. Transfusional Dept. Venice Area, Ospedale dell’Angelo, Mestre, Italy

    Gianluca Gessoni

  2. Laboratory Medicine, Ospedale Madonna della Navicella, Chioggia, Italy

    Sara Valverde

  3. Transfusional Service, Ospedale Madonna della Navicella, Chioggia, Italy

    Francesca Gessoni

  4. Cardiology and Intensive Coronary Unit, Ospedale Madonna della Navicella, Chioggia, Italy

    Letizia Valle, Marina Bortolotti & Roberto Valle

  5. Nephrology and Haemodialysis, Ospedale Madonna della Navicella, Chioggia, Italy

    Vincenzo Lidestri & Michele Urso

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  1. Gianluca Gessoni
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  2. Sara Valverde
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  3. Francesca Gessoni
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Correspondence to Gianluca Gessoni.

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Studies carried out on human being and animals

This study protocol was evaluated by the ethical committee of our institution.

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A written consent was obtained from each patient evaluated in this study.

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Gessoni, G., Valverde, S., Gessoni, F. et al. Glomerular filtration rate assessed by using creatinine and cystatin in patients treated with dabigatran. Riv Ital Med Lab 12, 243–248 (2016). https://doi.org/10.1007/s13631-016-0136-4

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  • DOI: https://doi.org/10.1007/s13631-016-0136-4

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