Medicina UPB

ISSN: 0120-4874
revista.medicina@upb.edu.co
Universidad Pontificia Bolivariana
Colombia

Delgado Restrepo, Jorge Fernando; Mesa Guerra, Ana Milena; Rodríguez Gázquez, María de los
Ángeles; Toro Montoya, Andrés Eduardo
Comparación de la depuración de creatinina en orina de 24 horas y estimación de función renal por
fórmula MDRD en pacientes con enfermedad renal crónica. Experiencia Susalud
Medicina UPB, vol. 30, núm. 1, enero-junio, 2011, pp. 30-35
Universidad Pontificia Bolivariana
Medellín, Colombia

Disponible en: http://www.redalyc.org/articulo.oa?id=159022489005

Cómo citar el artículo

Número completo
Sistema de Información Científica
Más información del artículo Red de Revistas Científicas de América Latina, el Caribe, España y Portugal
Página de la revista en redalyc.org Proyecto académico sin fines de lucro, desarrollado bajo la iniciativa de acceso abierto
*7<6:;4 $8A )7>: -)A =4;5E6D7G )-A K454 -! -=Ki,%\j j=+C+"-\

Comparación de la depuración de creatinina en orina de 24 horas

y estimación de función renal por fórmula MDRD en pacientes con
enfermedad renal crónica. Experiencia Susalud
Comparison of creatinine clearance in urine 24-hour volume and renal function estimation
from the MDRD formula in patients with Chronic Kidney Disease. Experience of Susalud

$4567 8759:9;4 *7<6:;4 =7>?57@41A -9: )B<79: )7>: CD755:2A ):5E: ;7 <4> F967<7> =4;5E6D7G CHGID7G3A -9;5J> !;D:5;4
K454 )49?4L:M

RESUMEN

Objetivo: 7N:<D:5 <: O4557<:OBP9 L O49O45;:9OB: 79?57 <: ;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:> L <: RP5SD<: )4;BTO:?B49
4R *B7? B9 =79:< *B>7:>7 1)*=*2 @:5: <: 7>?BS:OBP9 ;7 <: RD9OBP9 579:<U
Metodología: 7>?D;B4 :9:<E?BO4 ;7 @5D7V:> ;B:69P>?BO:>U W7 ?4SP B9R45S:OBP9 ;7 <: QB>?45B: O<E9BO: ;7 ( M'X @:OB79?7> 79?57
(Y L Z' :[4> O49 ;B:69P>?BO4 ;7 !9R75S7;:; 579:< O5P9BO: ;7 <: 79?B;:; @54S4?45: ;7 >:<D; WD>:<D;U \: 7>?BS:OBP9 ;7 <:
T<?5:OBP9 6<4S75D<:5 @45 <: RP5SD<: )*=* >7 QBG4 O49 <: O:<OD<:;45: ;7 <: ":?B49:< ]B;97L 84D9;:?B49U W7 O:<OD<P 7< O47TOB79?7
;7 O4557<:OBP9 L >7 7^@<45P <: O49O45;:9OB: O49 <: :LD;: ;7< 7>?:;E>?BO4 ]:@@:U

Resultados: 7< _0` ;7< 65D@4 7>?D;B:;4 7> R7S79B94 L <: 7;:; @54S7;B4 7> ;7 _aU0b('U( :[4>U !< @54S7;B4 ;7 <: ;7@D5:OBP9
79 45B9: ;7 &M Q45:> RD7 aXU0b&MU& S\cSB9 L 7< @54S7;B4 ;7 ;7@D5:OBP9 @45 )*=* RD7 a&U0b(ZU_ S\cSB9U \: O4557<:OBP9
79?57 <:> ;4> @5D7V:> RD7 S4;75:;: 1'U_Z2 L <: O49O45;:9OB: RD7 ;JVB< 1'U&_2U
Conclusiones: <: ;JVB< O49O45;:9OB: 79?57 <: ;7@D5:OBP9 79 45B9: ;7 &M Q45:> L @45 )*=* 79 7>?7 65D@4 ;7 @:OB79?7> 94
@75SB?7 >D675B5 >D D>4U ,49 <:> ;BTOD<?:;7> 79 <: 57O4<7OOBP9 7 B9?75@57?:OBP9 ;7 <: ;7@D5:OBP9 ;7 O57:?B9B9:A >7 57IDB757 ;7
9D7N4> 7>?D;B4> @:5: @4;75 57O4S79;:5 <: RP5SD<: )*=* 79 9D7>?5: @4V<:OBP9U

Palabras clave: 8:<<4 579:< O5P9BO4U .5D7V:> ;7 RD9OBP9 579:<U K:>: ;7 T<?5:OBP9 6<4S75D<:5U ,4<4SVB:U

ABSTRACT

Objective: ?4 O4S@:57 ?Q7 57>D<?> 4R O57:?B9B97 O<7:5:9O7 B9 ?Q7 &M#Q4D5 D5B97 4D?@D? dB?Q ?Q7 57>D<?> ;75BN7; R54S ?Q7 )*=*
R45SD<:U
Methods: :9:<L?BO:< >?D;L 4R ;B:694>?BO ?7>?>U +9R45S:?B49 d:> ?:e79 R54S ?Q7 S7;BO:< 57O45;> 4R ( M'X @:?B79?> :67; (Y#Z'
L7:5> dB?Q : ;B:694>B> 4R ,Q549BO ]B;97L *B>7:>7 B9 W%W-\%*U KQ7 7>?BS:?B49 4R ?Q7 6<4S75D<:5 T<?5:?B49 5:?7 VL ?Q7 )*=*
R45SD<: d:> ;497 D>B96 ?Q7 ":?B49:< ]B;97L 84D9;:?B49 O:<OD<:?45U -9 :9:<L>B> 4R <B97:5 O4557<:?B49 d:> O49;DO?7; :9; S:?OQB96
d:> 7^@<457; VL S7:9> 4R ?Q7 ]:@@: >?:?B>?BOU

1
)J;BO4 +9?759B>?:A @54R7>45A 8:OD<?:; ;7 )7;BOB9:U %9BN75>B;:; .49?BTOB: /4<BN:5B:9:A )7;7<<E9A ,4<4SVB:
2
)J;BO4 C7975:<U )7;7<<E9A ,4<4SVB:
3
!9R75S75:A *4O?45: 79 W:<D; .fV<BO:A @54R7>45:A 8:OD<?:; ;7 )7;BOB9:U %9BN75>B;:; .49?BTOB: /4<BN:5B:9:A )7;7<<E9A
,4<4SVB:
M
!>?D;B:9?7 ;7 @5765:;4A 8:OD<?:; ;7 )7;BOB9:U %9BN75>B;:; .49?BTOB: /4<BN:5B:9:A )7;7<<E9A ,4<4SVB:

,4557>@49;79OB:3 $4567 8759:9;4 *7<6:;4 =7>?57@4U ,45574 7<7O?5P9BO43 gR;5hD97U97?UO4

87OQ: ;7 57OBVB;43 Y ;7 ;BOB7SV57 ;7 &'('
87OQ: ;7 :@54V:OBP93 &Y ;7 S:5G4 ;7 &'((

30 !"!#$%" &'(( )!*+,+"- %./ 0'1(23 0'#0_

 ,4S@:5:OBP9 ;7 <: ;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:> L 7>?BS:OBP9 ;7 RD9OBP9 579:<
@45 RP5SD<: )*=* 79 @:OB79?7> O49 79R75S7;:; 579:< O5P9BO:U !^@75B79OB: WD>:<D;

Results: _0` 4R ?Q7 >?D;B7; 654D@ d:> R7S:<7 :9; ?Q7 :N75:67 :67 d:> _aU0 L7:5>U KQ7 :N75:67 O<7:5:9O7 B9 D5B97 &M Q4D5
N4<DS7 d:> aXU0b&MU& S\cSB9 :9; ?Q7 :N75:67 O<7:5:9O7 VL )*=* d:> a&U0b(ZU_ S\cSB9U KQ7 O4557<:?B49 V7?d779 ?Q7 ?d4
?7>?> d:> S4;75:?7 1_ZUY`2 :9; ?Q7 S:?OQB96 R45O7 d:> d7:e 1'U&_2
Conclusions: ?Q7 d7:e O49O45;:9O7 V7?d779 ?Q7 D5B97 &M#Q4D5 N4<DS7 O57:?B9B97 O<7:5:9O7 :9; ?Q7 )*=* R45SD<: B9
?QB> 654D@ 4R @:?B79?> ;47> 94? :<<4d R45 57O4SS79;B96 B?> D>7U *D7 ?4 ?Q7 ;BRTOD<?B7> B9 O4<<7O?B96 :9; B9?75@57?B96 O57:?B9B97
O<7:5:9O7A 97d >?D;B7> :57 57IDB57; ?4 57O4SS79; ?Q7 D>7 4R ?Q7 )*=* R45SD<: B9 4D5 @4@D<:?B49U

Keywords: eB;97L R:B<D57A OQ549BOk eB;97L RD9O?B49 ?7>?>k 6<4S75D<:5 T<?5:?B49 5:?7k ,4<4SVB:U

INTRODUCCIÓN @:OB79?7U !>?: RP5SD<: >7 57O4SB79;: @:5: D>4

!9 7< H57: ;7 97R54<46E:A D9: :;7OD:;:
7>?BS:OBP9 ;7 <: RD9OBP9 579:< 7> @5BS45;B:<
79 <: ;7?7OOBP9A 7N:<D:OBP9 L ?5:?:SB79?4 ;7 <:
79R75S7;:; 579:< O5P9BO:U \: BS@45?:9OB: ;7
7>?: 7N:<D:OBP9 5:;BO: 79 7< @:@7< ID7 >7 <7
Q: 57O494OB;4 : <: !9R75S7;:; 579:< O5P9BO:
1!=,2 O4S4 65:N7 L O57OB79?7 @54V<7S: ;7
>:<D; @fV<BO:(A&U
\: 7N:<D:OBP9 ;7 <: ?:>: ;7 T<?5:OBP9 6<4S75D<:5
1K8C2 7> D9: ;7 <:> S7;BOB497> SH> BS@45?:9?7>
@:5: 7>?:V<7O75 7< ;:[4 ID7 Q: >DR5B;4 7< 5B[P9
O49 <:> ;BR7579?7> 79R75S7;:;7>A ?4^B9:> 4
B9gD5B:> ;7 ;BN75>4 45;79A O49 7< T9 ;7 ;7?75SB9:5
<: O49;DO?: ID7 >7 Q: ;7 >76DB5 79 7< S:97g4 ;7
7>?4> @:OB79?7>A L >4V57 ?4;4A 79 D9 S4S79?4
@:5?BOD<:5A ;7T9B5 >B 7< @:OB79?7 57IDB757 4 94
?75:@B: ;7 577S@<:G4 579:<1U
!>?: 7N:<D:OBP9 ;7 <: T<?5:OBP9 6<4S75D<:5 >7
@D7;7 57:<BG:5 ;7 Sf<?B@<7> S:975:>3 D?B<BG:9;4
>D>?:9OB:> 7^P679:> :< 456:9B>S4A D>:9;4
RP5SD<:> : @:5?B5 ;7 ;:?4> 4V?79B;4> ;7 7^HS797>
;7 <:V45:?45B4 L ;:?4> :9?54@4SJ?5BO4>k O:;: D9:
;7 7<<:> O49 N79?:g:> L ;7>N79?:g:> ID7 @7>:9
O49 S:L45 RD75G: 79 ;7?75SB9:;:> OB5OD9>?:9OB:>U
\: 7OD:OBP9 )*=* 1@45 >D 94SV57 79 B96<J>A
)4;BTO:?B49 4R *B7? B9 =79:< *B>7:>72 @54N77 D9
7>?BS:;4 f?B< ;7 <: K8C 79 @:OB79?7> :;D<?4>&A0U
WB9 7SV:564A >7 :T5S: ID7 <: ;7@D5:OBP9 ;7
O57:?B9B9: 79 45B9: ;7 &M Q45:> 94 7> >D@75B45
: <: D?B<BG:OBP9 ;7 :<6D9:> RP5SD<:>1U \: RP5SD<:
)*=*MA :D9ID7 ?B797 <BSB?:OB497>A 57@57>79?: D9
:N:9O7 >4V57 7< D>4 ;7 <: O57:?B9B9: >J5BO: >4<:
4 79 <: 7>?BS:OBP9 ;7 <: K8CA >B79;4 >D @5B9OB@:<
N79?:g:A ID7 @D7;7 >75 O:<OD<:;: O49 7< N:<45 ;7
<: O57:?B9B9: L <4> ;:?4> ;7 7;:;A >7^4 L 5:G: ;7<
O<E9BO4 @45 8D9;:OBP9 ":OB49:< ;7< =B[P9 1KQ7
":?B49:< ]B;97L 84D9;:?B49A "]82A <: W4OB7;:;
-S75BO:9: ;7 "7R54<46E: 1-S75BO:9 W4OB7?L 4R
"7@Q54<46L2A L @45 7< .5465:S: ":OB49:< ;7
!;DO:OBP9 @:5: <: !9R75S7;:; =79:< ;7< +9>?B?D?4
Nacional de Salud de los Estados Unidos1U
!>?7 :5?EOD<4 7> @54;DO?4 ;7 <: B9N7>?B6:OBP9
ID7 ?DN4 O4S4 4Vg7?BN4 7N:<D:5 <: O4557<:OBP9
entre los resultados de la evaluación de la
RD9OBP9 579:< @45 ;7@D5:OBP9 ;7 O57:?B9B9: 79
45B9: ;7 &M Q45:> O49 <: 7>?BS:OBP9 ;7 <: K8C
@45 <: RP5SD<: )*=*U
METODOLOGÍA
W7 QBG4 D9 7>?D;B4 :9:<E?BO4 ;7 @5D7V:>
;B:69P>?BO:>A O49 7< T9 ;7 ;7?75SB9:5 7< 65:;4 ;7
57<:OBP9 94 O:D>:< 7^B>?79?7 79?57 ;4> @5D7V:>
1;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:>
L )*=*2U
W7 ?4SP B9R45S:OBP9 ;7 <: QB>?45B: O<E9BO:
;7 ( M'X @:OB79?7> 79?57 (Y L Z' :[4> O49
;B:69P>?BO4 ;7 !=, @75?797OB79?7> :< @5465:S:
;7 .54?7OOBP9 =79:< ;7 <: 79?B;:; @54S4?45: ;7
>:<D; 1!.W2 WD>:<D;A 79 )7;7<<E9A ;D5:9?7 <4>
:[4> &''_ : &''aA L ID7 ?DNB75:9 D9 7>?D;B4 ;7
;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:>U
\: 7>?BS:OBP9 ;7 <: T<?5:OBP9 6<4S75D<:5 @45
<: RP5SD<: )*=* >7 QBG4 O49 <: O:<OD<:;45:
;B>@49BV<7 79 <E97: 79 <: @H6B9: ;7 <: Kidney
Disease Outcomes Quality Initiative 1]*jl+2_U
\: B9R45S:OBP9 97O7>:5B: @:5: ODS@<B5 O49
7< 4Vg7?BN4 ;7< 7>?D;B4 >7 B9O<DLP 79 D9: V:>7

)!*+,+"- %./ 0'1(23 0'#0_ !"!#$%" &'(( 0(

*7<6:;4 $8A )7>: -)A =4;5E6D7G )-A K454 -! -=Ki,%\j j=+C+"-\

;7 ;:?4> 79 7< @5465:S: W?:?B>?BO:< .:Oe:67
R45 ?Q7 W4OB:< WOB79O7> 1W.WW2 @:5: oB9;4d>
(_U' 1W.WW +9OUA +/)A W4S75>A "7d p45eA %W-2A
<BO79OB: 4V?79B;: @45 <: !>OD7<: ;7 ,B79OB:> ;7
<: W:<D; ;7 <: %9BN75>B;:; .49?BTOB: /4<BN:5B:9:U
!< :9H<B>B> 7>?:;E>?BO4 ;7>O5B@?BN4 ;7 <:> N:5B:V<7>
OD:<B?:?BN:> >7 QBG4 S7;B:9?7 @54@45OB497>A L
<:> N:5B:V<7> OD:9?B?:?BN:> RD7549 7N:<D:;:> O49
S7;B;:> ;7 ?79;79OB: O79?5:< :O4S@:[:;:>
@45 >D> S7;B;:> ;7 ;B>@75>BP9U *7>@DJ> ;7
la verificación del criterio de normalidad se
D?B<BGP 7< O47TOB79?7 ;7 O4557<:OBP9 ;7 .7:5>49
@:5: O4S@:5:5 <4> 7>?:;B4> @45 ;7@D5:OBP9 ;7
O57:?B9B9: 79 45B9: ;7 &M Q45:> O49 <4> ;7 <:
RD9OBP9 579:< >76f9 7< @:5HS7?54 ;7 )*=*k <:
concordancia entre los estadios de la función
579:< ;7 <:> ;4> @5D7V:> 7N:<D:;:> 79 7>?7
7>?D;B4 >7 QBG4 O49 7< 7>?:;E>?BO4 ]:@@:U
8B9:<S79?7A 7< ?7>? ;7 <4> >B694> >7 7S@<7P @:5:
7N:<D:5 7< @45O79?:g7 ;7 @:OB79?7> ID7 ?DNB7549
7< SB>S4 7>?:;B4 79 <:> ;4> @5D7V:>U !9 ?4;4>
<4> O:>4>A <:> ;BR7579OB:> 79?57 <:> 7>?BS:OB497>
RD7549 O49>B;75:;:> >B69BTO:?BN:> >B 7< N:<45 ;7
@54V:VB<B;:; RD7 S7945 ID7 'U'_U
!9 <: RB6D5: ( >7 :@57OB: <: O4557<:OBP9
S4;75:;:S79?7 :<?: 79?57 <: )*=* L <:
;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:>
15m 'U_YA N:<45 @n'U''(2A <4 ID7 7^@<BO: 7< )*=*
79 7< 00UM` ;7 <: N:5B:9G: ;7 <: ;7@D5:OBP9 ;7
O57:?B9B9: 79 45B9: ;7 &M Q45:>U
\: ;BR7579OB: @54S7;B4 79?57 <:> ;4> @5D7V:>
79 7< SB>S4 @:OB79?7 75: ;7 aUX b _UX S<c
SB9c(UZ0S2U
El valor de concordancia en los estadios y la
RD9OBP9 579:< ;7 <:> ;4> @5D7V:> 7N:<D:;:> 79
7>?7 7>?D;B4A S7;B;: : ?5:NJ> ;7< 7>?:;E>?BO4
]:@@:A RD7 ;7< 'U&_M 1Gm0U&aA @n'U''(2A <4 ID7
SD7>?5: D9: RD75G: ;7 O49O45;:9OB: ;JVB<U
!< :9H<B>B> ;7< ?7>? ;7 <4> >B694> S4>?5P ID7 7<
_MU0` ;7 <4> @:OB79?7> ?DN4 7< SB>S4 7>?:;B4
79 <:> ;4> @5D7V:>k D9 (&U(` ?DN4 S:L457>
N:<457> 79 <: ;7@D5:OBP9 ;7 O57:?B9B9: ID7 79 7<
)*=*A L 79 7< 00Ua` >7 ;B4 7< O:>4 O49?5:5B4k <:>
anteriores diferencias fueron estadísticamente
>B69BTO:?BN:> 1G3(0UA(MA @n'U''(2U

\4> :>@7O?4> J?BO4> >7 :gD>?:549 : <:

=7>4<DOBP9 YM0' ;7 (XX0 ;7< )B9B>?75B4
;7 W:<D; ;7 ,4<4SVB: ID7 O49>B;75:
>B9 5B7>64 :ID7<<4> 7>?D;B4> 57:<BG:;4>
7^O<D>BN:S79?7 O49 576B>?54>U \:
B9R45S:OBP9 @:5: <: B9N7>?B6:OBP9 RD7
>DSB9B>?5:;: O49 <: :@54V:OBP9 ;7 <: !.W
WD>:<D;U

RESULTADOS

\:> O:5:O?75E>?BO:> 67975:<7> ;7< 65D@4

7>?D;B:;4 RD75493 @57;4SB9B4 ;7< >7^4
R7S79B94 1_0U'`2 L <: 7;:; @54S7;B4 RD7
;7 _aU0b('U( :[4>U K79B79;4 79 OD79?:
<: RD9OBP9 579:< >76f9 7< @:5HS7?54 ;7
;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M
Q45:>A RD7549 SH> R57OD79?7> <4> 7>?:;B4>
& L 0 1_0UX` L &XU'`A 57>@7O?BN:S79?72A
B6D:< 4V>75N:OBP9 >7 QBG4 O49 7< @:5HS7?54
)*=* 1MaUX` L MMU(`A 57>@7O?BN:S79?72U
1K:V<: (2 Figura 1. ,4557<:OBP9 79?57 )*=* L <: ;7@D5:OBP9
;7 O57:?B9B9: 79 45B9: ;7 &M Q45:>U

32 !"!#$%" &'(( )!*+,+"- %./ 0'1(23 0'#0_

 ,4S@:5:OBP9 ;7 <: ;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:> L 7>?BS:OBP9 ;7 RD9OBP9 579:<
@45 RP5SD<: )*=* 79 @:OB79?7> O49 79R75S7;:; 579:< O5P9BO:U !^@75B79OB: WD>:<D;

Tabla 1. Características generales ;7 ( M'X @:OB79?7> O49 !9R75S7;:; 579:< O5P9BO: @75?797OB79?7>
:< @5465:S: ;7 .54?7OOBP9 =79:< ;7 <: !.W WD>:<D;A 79 )7;7<<E9A &''_ # &''aU

Variable Valor
W7^4 R7S79B94A ` _0U'
!;:; 79 :[4>A @54S7;B4 b *! _aU0 b ('U(
*7@D5:OBP9 ;7 O57:?B9B9: 1S\cSB92A @54S7;B4 b *! aXU0 b &MU&
,57:?B9B9: >J5BO: 1S6c;\2A @54S7;B4 b *! (U(X b 'UM
)*=* 1S\cSB9c(UZ0S22A @54S7;B4 b *! a&U0 b (ZU_
!>?:;B4 @45 ;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:>A `
1 (MU0
2 _0UX
3 &XU'
M &U_
_ 'U&
!>?:;B4 ;7 <: RD9OBP9 579:< >76f9 7< @:5HS7?54 ;7 )*=*A 1`2
1 aUZ
2 MaUX
3 MMU(
M &U(
_ 'U0

DISCUSIÓN C:5OB:#":N7B54 et al.X 79O49?5:549 79 @:OB79?7>

\: ;7@D5:OBP9 ;7 O57:?B9B9:A L: >7: S7;B;: 4
7>?BS:;: : @:5?B5 ;7 OD:<IDB75: ;7 <:> RP5SD<:>
;B>@49BV<7>A 7> <: S7g45 S:975: ;7 7N:<D:5 <:
función renalaAZU !9 9D7>?54 7>?D;B4 >7 4V?DN4
@4O: O49O45;:9OB: 79?57 <4> 7>?:;B4> ;7
RD9OBP9 579:< 1>76f9 O5B?75B4> ]*jl+2 79?57 <:
;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:>
L <: RP5SD<: )*=*k >B9 7SV:564A OD:9;4 >7
O4S@:5:549 <4> 57>D<?:;4> 79 R45S: 9DSJ5BO:
>7 4V>75N: ID7 <: ;BR7579OB: 79 S\cSB9A ;7
SJ?4;4 : SJ?4;4A RD7 ;7 aUX S\cSB9c(UZ0S2A O49
;BR7579OB:> >B69BTO:?BN:>U q:<<:G64> >BSB<:57>
Q:9 >B;4 57@45?:;4> @45 ,:5:N:O: et al.YA 79
7< ID7 SD7>?5: ID7 <: K8C O4S@:5:;4 O49 <:
;7@D5:OBP9 ;7 O57:?B9B9: L ;7 D57: 1('U'Mb0U('
S\cSB9 L ('U__b0Ua' S<cSB9A 57>@7O?BN:S79?7 1@
n 'U'''(2 >7 O4557<:OB49:549 >B69BTO:?BN:S79?7
15m 'UZaA @ n 'U'''(2U !>: B9N7>?B6:OBP9 7>?BSP
<: ;BR7579OB: ;7 @54S7;B4> ;7 :SV:> @5D7V:>
79 aU_ S\cSB9U
O49 R:<<: 579:< O5P9BO: D9 @54S7;B4 ;7 T<?5:OBP9
6<4S75D<:5 ;7 (XUZ S\cSB9c(UZ0S2 @45 )*=*
L (XU0 S<cSB9c(UZ0S 2 @45 ;7@D5:OBP9 ;7
O57:?B9B9: O49 D9: ;BR7579OB: @54S7;B4 ;7 'UM
S<cSB9c(UZ0S2 1N:<45 @m 'U&a2U .754 ?:SVBJ9 >7
Q: 57@45?:;4 D9: @4V57 O4557<:OBP9 79?57 <:>
@5D7V:>A O4S4 7> 7< O:>4 ;7< 7>?D;B4 ;7 <7 =BOQ7
et alU10A 79 7< ID7A :< O4S@:5:5<4 O49 <: RP5SD<:
,4Oe54R?#C:D<?A ;B4 D9: S7g45 O4557<:OBP9 O49
7>?: f<?BS:U
\: RP5SD<: )*=* RD7 >D675B;: 79 7< 7>?D;B4
;7 \7N7L et al.11A @DV<BO:;4 79 7< :[4 ;7 (XXXA
L ;7>;7 79?49O7> Q:9 :@:57OB;4 7>?D;B4> 79
<4> ID7 >7 79OD79?5: O4557<:OBP9 L 4?54> 79 <4>
ID7 94k :<6D94> Q:9 57@45?:;4 ID7 <: RP5SD<:
)*=* 7> :@54@B:;: @:5: <: 7N:<D:OBP9 ;7 <:
función renal(&#(MA B9O<DL79;4 <4> ;B:VJ?BO4>(_A
L 4?54> 79 <4> ID7 94 >7 Q: 4V>75N:;4 ;BOQ:
O4557<:OBP9A 7>@7OB:<S79?7 79 :<6D94> 65D@4>
@4V<:OB49:<7>(aU

)!*+,+"- %./ 0'1(23 0'#0_ !"!#$%" &'(( 00

*7<6:;4 $8A )7>: -)A =4;5E6D7G )-A K454 -!
!9 7>?:;B4 & L 0A O49 O57:?B9B9: S7;B: r(U_ S6c
;\A <: )*=* @D7;7 >75 D>:;: @:5: 7>?BS:5 <:
?:>: ;7 T<?5:OBP9 6<4S75D<:5 ;D5:9?7 7< S49B?4574
L >76DBSB79?4 ;7 @:OB79?7> O49 *B:V7?7>
S7<<B?D> ?B@4 & ID7 7>?J9 57OBVB79;4 ?5:?:SB79?4
O49 B9>D<B9:A QB@46<BO7SB:9?7> 4 :SV4>(ZU
q:L ID7 ?7975 79 OD79?: ID7 <: ;7@D5:OBP9
;7 O57:?B9B9: 79 45B9: ;7 &M Q45:> ?B797 N:5B4>
B9O49N79B79?7> ID7 @D7;79 ;:5 D94> 57>D<?:;4>
ID7 94 O49OD75;:9 O49 <: RD9OBP9 579:<3 D94 7>
<: ;BR7579OB: @:5: 7>?BS:5 <: O57:?B9B9: >J5BO: @45
7< SJ?4;4 $:RRJA 7S@<7:;4 79 9D7>?5: OBD;:;k
4?5:>A >49 <:> N:5B:OB497> ;:;:> @45 <: >7O57OBP9
?DVD<:5 ;7 O57:?B9B9:A <: 57O4<7OOBP9 B9:;7OD:;:
;7 <: 45B9: L 7< :<S:O79:SB79?4 @54<496:;4 ;7
J>?:(YU
%9 :>@7O?4 @:5: ?7975 79 OD79?: 7> 7<
57>D<?:;4 ;7 <: O57:?B9B9: >J5BO:A ID7 ?B797
N:5B4> :>@7O?4> ID7 N:<7 <: @79: S79OB49:5
@:5: Q:O75 D9: :;7OD:;: B9?75@57?:OBP9 ;7 >D>
57>D<?:;4>A O4S4 7> QB@75?54T: O4S@79>:;45:
ID7 >7 @57>79?: 79 7< S4S79?4 ;7 >DR5B5 <7>BP9
6<4S75D<:5A <4 ID7 Q:O7 ID7 >D> 9BN7<7> 94 >7
S4;BTID79 : <: SB>S: N7<4OB;:;(XA&'A N:5B:OBP9
79 <: @54;DOOBP9 ;7 O57:?B9B9:A O:SVB4> 79 <:
>7O57OBP9 ;7 J>?:A 7<BSB9:OBP9 7^?5:5579:< ;7
<: SB>S: L <4> SJ?4;4> 7S@<7:;4> @:5: >D
S7;BOBP9U
\:> ;B>O57@:9OB:> ID7 >7 79O49?5:549 :<
O4S@:5:5 <4> 57>D<?:;4> @45 ;7@D5:OBP9 ;7
O57:?B9B9: L <4> ;7 >D> ;BR7579?7> 7>?:;B4>A >76f9
<: 6DE: ]*l+A >7 @D7;7 7^@<BO:5 @45 7< Q7OQ4 ;7
ID7 @D7;7 >75 ?:9 @7ID7[:A ;7 Q:>?: _ S\cSB9A
L @D7;79 O<:>BTO:5 79 ;BR7579?7> 7>?:;B4>U
.:5: <: B9?75@57?:OBP9 ;7 <4> 57>D<?:;4> ;7
;7@D5:OBP9 ;7 O57:?B9B9: ;7V7 @57N:<7O75 <:
@57>79?:OBP9 O<E9BO: LA >B VB79 <4> 57>D<?:;4> ;7 <:
;7@D5:OBP9 :LD;:9 @:5: O<:>BTO:5 : D9 @:OB79?7
79 D9 ;7?75SB9:;4 7>?:;B4A 7> D9 @:5HS7?54 ;7
O<:>BTO:OBP9 L f?B< ;D5:9?7 7< >76DBSB79?4 ;7 <4>
@:OB79?7> O49 79R75S7;:; 579:<A SH> ID7 79 >D
7N:<D:OBP9 @D9?D:<U
,49 7>?4> 57>D<?:;4> 94 7> @4>BV<7 57O4S79;:5
7< D>4 ;7 )*=* @:5: 577S@<:G:5 <: ;7@D5:OBP9
0M !"!#$%" &'((
-=Ki,%\j j=+C+"-\
;7 45B9: 79 &M Q45:>A >B9 7SV:564A O577S4> ID7
@4;5E: >75 D9: RP5SD<: f?B< 79 9D7>?54 S7;B4U .45
?:< 5:GP9A >7 gD>?BTO: Q:O75 4?54> 7>?D;B4> @:5:
7N:<D:53 :2 <: 7>?:9;:5BG:OBP9 ;7 <: 57:<BG:OBP9 ;7
O57:?B9B9:A V2 <4> R:O?457> ID7 B9?75NB7979 79 <4>
57>D<?:;4> ;7 7>?:> @5D7V:>A L O2 <: O4S@:5:OBP9
O49 SJ?4;4> B9N:>BN4> 79 9D7>?5: @4V<:OBP9U
\: O49O<D>BP9 ;7 9D7>?54 7>?D;B4 7> ID7 Q:L
D9: ;JVB< O49O45;:9OB: 79?57 <: ;7@D5:OBP9 ;7
O57:?B9B9: 79 45B9: ;7 &M Q45:> L <: ;7@D5:OBP9
@45 )*=* 79 7>?7 65D@4 ;7 @:OB79?7>A ID7 94
@75SB?7 >D675B5 >D D>4U !>?: B9R7579OB: >7 Q:O7
@45ID7 >7 Q:9 ?79B;4 79 OD79?: <:> ;BTOD<?:;7>
O49 <: ;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7
&M Q45:>A >D 57O4<7OOBP9 7 B9?75@57?:OBP9A 7>
;7OB5A 7> @57OB>4 Q:O75 9D7N4> 7>?D;B4> @:5:
57O4S79;:5 7< 7S@<74 ;7 <: RP5SD<: )*=*
79 9D7>?5: @4V<:OBP9U WB9 7SV:564A <: RP5SD<:
)*=* 7> f?B< 79 <: 7>?BS:OBP9 ;7 <: K8C 79
@:OB79?7> O49 !=, L @4;5E: D>:5>7 O4S4
:<?759:?BN:U
DECLARACIÓN DE CONFLICTO
DE INTERESES
\4> :D?457> ;7O<:5:9 94 ?7975 9B96f9 O49sBO?4
de intereses
FINANCIACIÓN DE LA INVESTIGACIÓN
-5?EOD<4 @54;DO?4 ;7 <: B9N7>?B6:OBP9 ID7 <<7N:
7< SB>S4 94SV57 L ID7 57OBVBP :@4L4 ;7 <: !.W
Susalud y de la Facultad de Medicina de la
%9BN75>B;:; .49?BTOB: /4<BN:5B:9:U
AGRADECIMIENTOS
\4> :D?457> :65:;7O79 @54RD9;:S79?7 :< 65D@4
;7 @75>49:> ;7 <4> ;7@:5?:S79?4> ;7 -5OQBN4
7 QB>?45B:> O<E9BO:> ;7 <: !.W WD>:<D; @45 >D
O4<:V45:OBP9A :S:VB<B;:; L ;B>@49BVB<B;:;U
)!*+,+"- %./ 0'1(23 0'#0_
 ,4S@:5:OBP9 ;7 <: ;7@D5:OBP9 ;7 O57:?B9B9: 79 45B9: ;7 &M Q45:> L 7>?BS:OBP9 ;7 RD9OBP9 579:<
@45 RP5SD<: )*=* 79 @:OB79?7> O49 79R75S7;:; 579:< O5P9BO:U !^@75B79OB: WD>:<D;

(0U =D<7 -A \:5>49 KA /756>?5:<Q !U %>B96 >75DS O57:?B9B97

REFERENCIAS
(U ":?B49:< ]B;97L 84D9;:?B49U ]c*jl+ O<B9BO:< @5:O?BO7
6DB;7<B97> R45 OQ549BO eB;97L ;B>7:>73 7N:<D:?B49A
O<:>>BTO:?B49A :9; >?5:?BTO:?B49U -S $ ]B;97L *B>U &''&k
0X 1& >D@@< (23W(#&aaU
&U \7N7L -WA /4>OQ $.A \7dB> $/A C57797 KA =4675> "A
=4?Q *U - S457 :OOD5:?7 S7?Q4; ?4 7>?BS:?7 6<4S75D<:5
T<?5:?B49 5:?7 R54S >75DS O57:?B9B973 : 97d @57;BO?B49
7ID:?B49U )4;BTO:?B49 4R *B7? B9 =79:< *B>7:>7 W?D;L
C54D@U -99 +9?759 )7;U (XXXk (0'3Ma(#Z'U
?4 7>?BS:?7 6<4S75D<:5 T<?5:?B49 5:?73 -OOD5:OL B9 644;
Q7:<?Q :9; B9 OQ549BO ]B;97L ;B>7:>7U -99 +9?759 )7;U
&''Mk (M(3X&XU
(MU 854B>>:5? )A =4>>75? $A $:OID4?,U .57;BO?BN7
@75R45S:9O7 4R ?Q7 )*=* :9; ,4Oe54R?#C:D<?7ID:?B49?>
R45 7>?BS:?B96 579:< RD9O?B49U $ -S W4O "7@Q54<U &''_k
(a3Za0U
(_U \:V7567 -U ,4S@:5B>49 4R O57:?B9B97 O<7:5:9O7
7>?BS:?7> dB?Q 54D?B97 S7:>D57; O<7:5:9O7U
,<B9/B4OQ7SU &''Zk M'3(&MzZU

0U \7N7L -WA C57797 KA ]D>7e $oA /7Oe C$U - >BS@<BT7; (aU =B6:<<7:D {A \:>>7D5 ,A .75<7S4B97 ,A /:5?Q7 "A
7ID:?B49 ?4 @57;BO? 6<4S75D<:5 T<?5:?B49 5:?7 R54S >75DS =:RR:B?B9 ,A \BD ,A et al. Estimation of glomerular
O57:?B9B97U $ -S W4O "7@Q54<U &'''k ((3(__-U T<?5:?B49 5:?7 B9 ;B:V7?BO >DVg7O?>3 ,4OeO54R? R45SD<:
45 S4;BRBO:?B49 4R *B7? B9 =79:< *B>7:>7 >?D;L
MU *:NB7> *A WQ4Oe "U -67 OQ:967> B9 6<4S75D<:5 T<?5:?B49 7ID:?B49|*B:V7?7> )7?:VU &''a 87Vk0&1(23_a#a&
5:?7A 7RR7O?BN7 579:< @<:>S:A :9; ?DVD<:5 7^O57?45L
O:@:OB?L B9 :;D<?> S:<7>U $ ,<B9 +9N7>?U (X_'k &X3MXa# (ZU C75OQS:9 8A K496 $A %?G>OQ97B;75 ])A qD<< =\A x5:Be:
_'ZU WA %;:L:>:9e:5 $A et al. WD@75B45B?L 4R ?Q7 )4;BTO:?B49
4R *B7? B9 =79:< *B>7:>7 7ID:?B49 4N75 ?Q7 ,4OeO54R?z
_U ":?B49:< ]B;97L 84D9;:?B49U ,:<OD<:?45> R45 Q7:<?Q C:D<? 7ID:?B49 B9 >O5779B96 R45 BS@:B57; eB;97L RD9O?B49
O:57 @54R7>>B49:<> t+9?7597?uU "7d p45e3 ":?B49:< B9 $:@:97>7 -S75BO:9>U *B:V7?7> =7> ,<B9 .5:O?U &''Zk
]B;97L 84D9;:?B49k &'(( t:OO7>4 _ ;7 gD9B4 ;7 &''YuU ZZ30&'z&aU
*B>@49BV<7 793 Q??@3ccdddUeB;97LU456c@54R7>>B49:<>c
e;4IBc6R5vO:<OD<:?45UORS (YU +S:B !A q45B4 )A "B??: ]U !>?BS:?B49 4R 6<4S75D<:5
T<?5:?B49 5:?7 VL ?Q7 )*=* >?D;L 7ID:?B49 S4;BT7;
aU o7>>49 \U .QL>B4<46L 4R ?Q7 QDS:9 eB;97LU "7d p45e3 R45 $:@:97>7 @:?B79?> dB?Q OQ549BO eB;97L ;B>7:>7U ,<B9
C5D97 w W?5:?49k (XaXU Z(&@U !^@ "7@Q54<U &''Zk ((1(23M(#_'U
ZU WSB?Q qU ,4S@:5:?BN7 @QL>B4<46L 4R ?Q7 eB;97LU +93 (XU 849?>75J "A W:<B9:> +A /49:< $A /:LJ> /A =BV: $A
WSB?Q qA 7;B?45U KQ7 eB;97L3 >?5DO?D57 :9; RD9O?B49 K4557> 8A et al. -57 @57;BO?B49 7ID:?B49> R45 6<4S75D<:5
B9 Q7:<?Q :9; ;B>7:>7U "7d p45e3 j^R45; %9BN75>>B?L T<?5:?B49 5:?7 D>7RD< R45 ?Q7 <496#?75S S49B?45B96 4R ?L@7
.57>>k (X_(U @U _&'#ZMU & ;B:V7?BO @:?B79?>|"7@Q54< *B:< K5:9>@<:9?U &''ak
YU ,:5:N:O: 8A -554V:> )A \D9: !A ":5:9g4 )A .BG:554 &(1Y23&(_&#YU
$\A W:9OQ7G#,:>:;4 !U *BRR7579O7> V7?d779 ?Q7 &'U W:^79: =A K454 =*U -@@54:OQ ?4 ?Q7 @:?B79? dB?Q 579:<
6<4S75D<:5 RB<?5:?B49 5:?7 7>?BS:?7; VL ?Q7 )*=* ;B>7:>7U +93 /579975 /) 7;B?45U /579975 :9; =7O?45>U
7ID:?B49 :9; ?Q7 S7:>D57S79? 4R O57:?B9B97 :9; D57: KQ7 eB;97LU Y?Q 7;U .QB<:;7<@QB:3 WD:9;75>k &''YU @U
O<7:5:9O7 B9 D9>7<7O?7; @:?B79?> dB?Q ?75SB9:< 579:< Z'_z _&U
B9>DRTOB79OLU "7R54<46B:U &''&k&&1_23M0&#ZU
XU C:5OE:#":N7B54 =A =4;5B6D7G#,:5S49: -A .757G#
849?H9 )U -6577S79? V7?d779 ?d4 54D?B97 S7?Q4;>
4R 7>?BS:?B49 4R 6<4S75D<:5 T<?5:?B49 5:?7 B9 @:?B79?>
dB?Q :;N:9O7; :9; ?75SB9:< OQ549BO 579:< R:B<D57U Clin
"7@Q54<U &''_ jO?kaM1M23&Z(#Y'U
('U \7 =BOQ7 )A x7S<B9 -!A !5:>SD> =KA *:NB;> )=U -9
:D;B? 4R &M#Q4D5 O57:?B9B97 O<7:5:9O7 S7:>D57S79?>
:? KL675V756 q4>@B?:< :9; O4S@:5B>49 dB?Q @57;BO?B49
7ID:?B49>U W -R5 )7; $U &''Z jO?kXZ1('23XaY#Z'U
((U \7N7L -WA /4>OQ $.A \7dB> $/U - )457 -OOD5:?7
S7?Q4; ?4 7>?BS:?7 6<4S75D<:5 T<?5:?B49 5:?7 R54S >75DS
O57:?B9B973 : 97d @57;BO?B49 7ID:?B49U -99 +9?759 )7;U
(XXXk (0'3Ma(#MZ'U
(&U .466B4 !*A o:96 yA C57797 KU .75R45S:9O7 4R ?Q7
S4;BTO:?B49 4R ;B7? B9 579:< ;B>7:>7 :9; ,4Oe54R?#
C:D<? 7ID:?B49> B9 ?Q7 7>?BS:?B49 4R C8= B9 Q7:<?Q :9;
B9 OQ549BO ]B;97L ;B>7:>7U $ -S W4O "7@54<U &''_k
(a3M_XU

)!*+,+"- %./ 0'1(23 0'#0_ !"!#$%" &'(( 0_