ĐÁNH GIÁ GIÁ TRỊ CỦA CREATININ HUYẾT THANH TRONG PHÁT HIỆN TỔN THƯƠNG THẬN THEO TIÊU CHUẨN eGFR VÀ ACR Ở BỆNH NHÂN NGOẠI TRÚ TẠI BỆNH VIỆN ĐA KHOA NHẬT TÂN, TỈNH AN GIANG, NĂM 2026

Abstract

Objective: To determine the prevalence of kidney damage according to eGFR and ACR criteria and to evaluate the diagnostic value of serum creatinine in detecting kidney damage among outpatients.

Subjects and methods: A retrospective cross-sectional study was conducted on 400 patients aged 18 years or older who underwent serum creatinine, urinary creatinine, and urinary albumin testing at Nhat Tan General Hospital from January to June 2026. Kidney damage was defined as eGFR <60 mL/min/1.73 m² and/or ACR ≥30 mg/g. The diagnostic performance of serum creatinine was assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results: The mean age was 56.81 ± 13.28 years, and 56.2% were female. The prevalence of hypertension and diabetes mellitus was 64.3% and 65.0%, respectively. The prevalence of eGFR <60 mL/min/1.73 m² was 15.3%, while ACR ≥30 mg/g was observed in 31.8% of patients. Overall, 37.5% of patients had kidney damage according to eGFR and/or ACR criteria. Notably, 23.5% of patients with normal serum creatinine still had kidney damage. Serum creatinine showed a sensitivity of 37.3%, specificity of 96.8%, PPV of 87.5%, and NPV of 72.0%.

Conclusion: Serum creatinine alone has low sensitivity for detecting kidney damage and may miss a substantial proportion of affected patients. Combined assessment of eGFR and ACR may improve the early detection of kidney damage.