Commentary: Renal Function Estimation and Cockcroft–Gault Formulas for Predicting Cardiovascular Mortality in Population-Based, Cardiovascular Risk, Heart Failure and Post-Myocardial Infarction Cohorts: The Heart ‘OMics’ in AGEing (HOMAGE) and the High-Risk Myocardial Infarction Database Initiatives

In a recent study, Ferreira and colleagues describe the association of common equations to renal function via “estimated glomerular filtration rate” (eGFR) with mortality. The suggest that while the Cockcroft–Gault-body surface area (BSA) method is more accurate predicting cardiovascular mortality in patients with existing cardiovascular risk, the CKD-EPI(Chronic Kidney Disease Epidemiology Collaboration equation) provides the best compromise renal function and cardiovascular mortality prediction. As the authors state, the measurement accurate renal function is important in the diagnosis and treatment of chronic kidney (CKD), adjustment of drug doses, and decision-making regarding renal replacement therapy. all methods described by Ferreira et al., eGFR measurement is based on serum creatinine. Creatinine is a 113-kDa breakdown product of muscle metabolism and is the commonly used filtration marker and indicator of renal function. However, its measurement from a variety of analytical interferences and standardization problems. Such-GFR determinants include age, sex, and ethnicity. Muscle mass and dietary protein intake can also affect creatinine concentrations; both these factors often concomitant with exercise levels. In a population muscle wasting and inadequate physical activity and intake is problematic, we feel it is important to highlight critique of creatinine-based eGFR in CKD, and how can be influenced by difference factors, principally mass, and exercise. We also examine the role of cystatin (CysC) and its role as a confirmatory biomarker in these