Estimation of GFR by MDRD Formula and Its Correlation to Cockcroft-Gault Equation in Five Stages of Chronic Kidney Disease
- 1 Department of Medicine, Aga Khan University, Karachi, Pakistan
- 2 Liaquat National Hospital, Karachi, Pakistan
- 3 Liaquat National Hospital, Karachi, Pakistan
Abstract
Background: Purpose of our study was to find out correlation between estimated Glomerular Filtration Rate (GFR) by Modification of Diet in Renal Disease (MDRD) formula and Glomerular Filtration Rate by Cockcroft-Gault equations, in patients with chronic kidney disease (CKD), and to see whether they can be used interchangeably. Methods : We conducted a cross section study of 70 patients presented to the nephrology clinic over a period of one year. We compared the Glomerular Filtration Rate by these two formulas in five stages of Chronic Kidney Disease. Abbreviated 4 variable Modification of Diet in Renal Disease formula was used. Results : Age range was 15 - 79 years; Male 49%, Female 51%. The correlation (r) between eGFR by MDRD and eGFR by Cockcroft-Gault equation for CKD stages 1 to 5 was 0.64; 0.31; 0.32; 0.67; and 0.45 respectively. The correlation (r) between creatinine clearance by 24 hour urine collection and MDRD formula was 0.84 (P: 0.001). The correlation (r) between creatinine clearance by 24 hour urine collection Cockcroft-Gault equation was 0.79 (P: 0.001). Conclusion : We conclude that Cockcroft-Gault equation correlates best with MDRD formula at CKD stages 4 and one. Cockcroft-Gault equation underestimated eGFR in stages 1, 2 and 3 of chronic Kidney Disease .
- T. H. Jafar, C. H. Schmid and A. S. Levey, “Serum Creatinine as Marker of Kidney Function in South Asia: A Study of Reduced GFR in Adults in Pakistan,” Clinical Journal of the American Society of Nephrology, Vol. 16, No. 5, 2005, pp. 1413-1419. doi:10.1681/ASN.2004121100
- G. Eknoyan and N. Levin (Co-Chairs Advisory Board of National Kidney Foundation), et al., “K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification,” American Journal of Kidney Diseases, Vol. 39, No. 5, 2002, pp. S1-S266. doi:10.1016/S0272-6386(02)70054-1
- A. S. Levey, J. P. Bosch, J. B. Levis, T. Greene, N. Rogers and D. Roth, “A More Accurate Method to Estimate Glomerular Filtration Rate from Serum Creatinine: A New Prediction Equation. Modification of Diet in Renal Disease Study Group,” Annals of Internal Medicine, Vol. 130, No. 6, 1999, pp. 461-470.
- D. W. Cockcroft and M. H. Gault, “Prediction of Creatinine Clearance from Serum Creatinine,” Nephron, Vol. 16, No. 1, 1976, pp. 31-41. doi:10.1159/000180580
- G. Rostoker, P. Andrivet, I. Pham, M. Griuncelli and S. Adnot, “A Modified Cockcroft-Gault Formula Taking into Account the Body Surface Area Gives a More Accurate Estimation of the Glomerular Filtration Rate,” Journal of Nephrology, Vol. 20, No. 5, 2007, pp. 576-585.
- A. Schoker, M. A. Hossain, T. Koru-Sengul, D. L. Raju and D. Cockcraft, “Performance of Creatinine Clearance Equation on the Original Cockcraft-Gault Population,” Clinical Nephrology, Vol. 66, No. 2, 2006, pp. 89-97.
- A. S. Levey, J. Coresh, T. Greene, J. Marsh, L. A. Stevens, J. W. Kusek and F. E. Van Lente, “Expressing the Modification of Diet in Renal Disease Study Equation for Estimating GFR with Standardized Serum Creatinine Values,” Clinical Chemistry, Vol. 53, No. 4, 2007, pp. 7666-7672. doi:10.1373/clinchem.2006.077180
- A. S. Levey, J. Coresh, T. Greene, L. A. Stevens, Y. Zhang, S. Hendriksen, et al., “Using Standardized Serum Creatinie Values in the Modification of Diet in Renal Disease Study. Equation for Estimating GFR,” Annals of Internal Medicine, Vol. 145, No. 4, 2006, pp. 247-254.
- L. A. Stevens, J. Coresh, H. I. Feldman, T. Greene, J. P. Lash, R. G. Nelson, et al., “Evaluation of the Modification of Diet in Renal Diease Study Equation in a Large Diverse Population,” Journal of the American Society of Nephrology, Vol. 18, No. 10, 2007, pp. 2749-2757. doi:10.1681/ASN.2007020199
- X. Wang, J. Lewis, L. Appel, D. Cheek, G. Contreras, M. Faulkner, et al., “Validation of Creatinine Based Estimates of GFR When Evaluating Risk Factors in Longitudinal Studies of Kidney Disease,” Journal of the American Society of Nephrology, Vol. 17, No. 10, 2006, pp. 2900-2909. doi:10.1681/ASN.2005101106