Evaluation of MDRD4, CKD‐EPI, BIS‐1, and modified Cockcroft–Gault equations to estimate glomerular filtration rate in the elderly renal‐transplanted recipients

Abstract

Equations to estimate glomerular filtration rate (eGFR) were developed in patients using the variables age, body weight, and serum creatinine, which may be different in the elderly. Elderly renal transplant patients (EG; n=70; mean age 65 ± 4 y) who measured plasma Cr-EDTA-Clearance (mGFR) had mGFR compared to eGFR obtained by the Cockcroft-Gault corrected by body surface area (CG-BSA), the modification of diet in renal disease (MDRD-4), the Berlin Initiative Study (BIS-1), and the chronic kidney disease epidemiology collaboration (CKD-EPI). Results were validated using a cohort of 43, of the 70 elderly recipients, who performed a second Cr-EDTA-Clearance. Mean mGFR was 47 ± 16 mL/min/1.73 m and statistically lower than eGFR by MDRD (52 ± 19, P=.001) and BIS-1 (51 ± 13, P=.007) but not different from the CG-BSA (47 ± 15) and CKD-EPI (49 ± 18). The CKD-EPI and CG-BSA presented the lowest bias but only CKD-EPI also showed the highest 30% and 10% accuracy. The same findings were repeated in the validation set. For a cohort of elderly recipients ≥65 years (n=35, 68 ± 3y), the CKD-EPI performed better with the lowest bias (0 ± 12 mL/min/1.73 m ) and best 30% and 10% accuracy. The CKD-EPI equation is a valuable tool to monitor GFR in the elderly RTx recipients.

Effect of polyoma viremia on 3‐year allograft kidney function

“…There is a consensus that evaluation of renal function based on SCr and not with the equations developed to estimate GFR, may introduce bias to the renal function analysis . We used the MDRD‐4 equation to evaluate eGFR.…”

Estimated glomerular filtration rate in stable older kidney transplant recipients-are present algorithms valid? A national cross-sectional cohort study

“…In the present analyses, equations were not evaluated in nonelderly adult KTR. In previous publications, the accuracy in nonelderly KTR has been described to be lower than what is reported for elderly in the present analysis . The performance of the newer equations should consequently be further evaluated in future studies including nonelderly KTR.…”

“…Consequently, none of the development populations for the existing GFR equations were representative for older KTR. The equations are, with a few exceptions , not evaluated in an elderly population of KTR, and as far as we know, no studies have evaluated eGFR equations in KTR older than 70 years. Masson et al .…”

“…Consequently, none of the development populations for the existing GFR equations were representative for older KTR. The equations are, with a few exceptions [12][13][14][15], not evaluated in an elderly population of KTR, and as far as we know, no studies have evaluated eGFR equations in KTR older than 70 years. Masson et al [16] compared the CKD-EPI with the Modification of Diet in Renal Diseases (MDRD) [17] equation in KTR and found that the CKD-EPI did not offer a better prediction of GFR.…”

Performance of the CKD-EPI and MDRD equations to estimate the glomerular filtration rate: a systematic review of Latin American studies

“…In total, we identified 379 records after removing duplicates, of which we full-text reviewed 31 potentially eligible records, excluding 19 (reasons are detailed in Additional file 2) and including 12 (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). In addition, we did not identify new studies after searching the lists of references of all included studies, and the lists of articles that cited each of the included studies (through Google Scholar) ( Fig.…”