Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate
- PMID: 16908915
- DOI: 10.7326/0003-4819-145-4-200608150-00004
Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate
Erratum in
- Ann Intern Med. 2008 Oct 7;149(7):519
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Correction: Using Standardized Serum Creatinine Values in the Modification of Diet in Renal Disease Study Equation.Ann Intern Med. 2021 Apr;174(4):584. doi: 10.7326/L21-0010. Ann Intern Med. 2021. PMID: 33872525 No abstract available.
Abstract
Background: Glomerular filtration rate (GFR) estimates facilitate detection of chronic kidney disease but require calibration of the serum creatinine assay to the laboratory that developed the equation. The 4-variable equation from the Modification of Diet in Renal Disease (MDRD) Study has been reexpressed for use with a standardized assay.
Objective: To describe the performance of the revised 4-variable MDRD Study equation and compare it with the performance of the 6-variable MDRD Study and Cockcroft-Gault equations.
Design: Comparison of estimated and measured GFR.
Setting: 15 clinical centers participating in a randomized, controlled trial.
Patients: 1628 patients with chronic kidney disease participating in the MDRD Study.
Measurements: Serum creatinine levels were calibrated to an assay traceable to isotope-dilution mass spectrometry. Glomerular filtration rate was measured as urinary clearance of 125I-iothalamate.
Results: Mean measured GFR was 39.8 mL/min per 1.73 m2 (SD, 21.2). Accuracy and precision of the revised 4-variable equation were similar to those of the original 6-variable equation and better than in the Cockcroft-Gault equation, even when the latter was corrected for bias, with 90%, 91%, 60%, and 83% of estimates within 30% of measured GFR, respectively. Differences between measured and estimated GFR were greater for all equations when the estimated GFR was 60 mL/min per 1.73 m2 or greater.
Limitations: The MDRD Study included few patients with a GFR greater than 90 mL/min per 1.73 m2. Equations were not compared in a separate study sample.
Conclusions: The 4-variable MDRD Study equation provides reasonably accurate GFR estimates in patients with chronic kidney disease and a measured GFR of less than 90 mL/min per 1.73 m2. By using the reexpressed MDRD Study equation with the standardized serum creatinine assay, clinical laboratories can report more accurate GFR estimates.
Comment in
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Decreased kidney function in the elderly: clinical and preclinical, neither benign.Ann Intern Med. 2006 Aug 15;145(4):299-301. doi: 10.7326/0003-4819-145-4-200608150-00010. Ann Intern Med. 2006. PMID: 16908921 No abstract available.
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Estimated glomerular filtration rate.Ann Intern Med. 2007 Jan 2;146(1):74; author reply 74-5. doi: 10.7326/0003-4819-146-1-200701020-00020. Ann Intern Med. 2007. PMID: 17200230 No abstract available.
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