5PSQ-031 Concordance between glomerular filtration rate equations in patients with chronic kidney disease treated with heparin and their relationship with bleeding risk

<h3>Background and Importance</h3> The estimation of glomerular filtration rate (GFR) is used to monitor renal function (RF) in patients with chronic kidney disease (CKD). It is also used in clinical practice to adjust the dosage of certain drugs, like as low molecular weight heparins (LMWH), due to the high-risk of bleeding, especially in patients with CKD. <h3>Aim and Objectives</h3> To compare the CKD-EPI, MDRD-4 and MDRD-IDMS equations for estimating GFR. To assess the relationship between GFR and bleeding risk in patients treated with LMWH. <h3>Material and Methods</h3> A prospective observational study carried out in a second-level hospital from May 2024 to October 2024, involving 51 patients hospitalised with CKD, categorised into three groups based on creatinine levels: mild CKD (&lt;1.5g/dL), moderate CKD (1.6g/dL-2.5g/dL) and severe CKD(&gt;2.5g/dL). Patients with acute, pre-renal or exacerbated renal disease were excluded. We reviewed electronic medical records in Mambrino XXI, compiling the data in Excel and performing statistical analysis using the SPSS. Specifically, we applied Student’s t-test, Chi-squared and frequency analysis tests to assess the statistical significance of the collected data. <h3>Results</h3> After a comparison of the GFR rate with the three calculators, it was observed that patients with mild CKD had greater variability in GFR between calculators compared to those with severe CKD. Furthermore, it could be corroborated that the values obtained with CKD-EPI were always lower than those obtained with MDRD-IDMS (average difference of 2.79 mL/min, 2.14 mL/min and 1.30 mL/min in mild, moderate and severe CKD, respectively), and these, in turn, lower than MDRD-4 (average difference of 4.83mL/min, 3.86 mL/min, 2.31 mL/min in mild, moderate and severe CKD, respectively), with two-factor statistical significance (p&lt;0.001). Bleeding rates were nil in patients with mild CKD, while those with severe CKD were slightly higher (35.71%) compared to moderate CKD (24%), with no statistical significance between the two groups (p=0.664). In conclusion, 50% of patients in the moderate group did not require dosage adjustment for renal function with MDRD-4 and MDRD-IDMS calculators but did with CKD-EPI. <h3>Conclusion and Relevance</h3> Our study confirms the variability between calculators, and an overestimation of GFR can be seen when using MDRD-4 and MDRD-IDMS. As in other studies the safest calculator in CKD is CKD-EPI as it requires earlier dosage adjustment and thus avoids possible bleeding. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest