Is estimated glomerular filtration rate suitable for stratification of chronic kidney disease?

Lippi, Giuseppe; Salvagno, Gian Luca; Guidi, Gian Cesare

doi:10.1080/00365510701663368

Cited by 3 publications

(1 citation statement)

References 2 publications

(4 reference statements)

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“…The present study focuses on how the MDRD-eGFR performs in similar cohorts in relation to S-Creatinine which is the primary, measured quantity. This relation has been poorly studied but two independent studies were recently published 11 , 12 .…”

Section: Discussionmentioning

confidence: 99%

Does eGFR improve the diagnostic capability of S-Creatinine concentration results? A retrospective population based study

Kallner

Ayling²,

Khatami³

2008

Int. J. Med. Sci.

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The use of MDRD-eGFR to diagnose Chronic Kidney Disease (CKD) is based on the assumption that the algorithm will minimize the influence of age, gender and ethnicity that is observed in S-Creatinine concentration and thus allow a single cut-off at which further diagnostic and therapeutic actions should be considered. This hypothesis is tested in a retrospective analysis of outpatients (N=93,404) and hospitalised (N=35,572) patients in UK and Sweden, respectively. An algorithm based on the same model as the MDRD-eGFR algorithm was derived from simultaneously measured S-Creatinine concentrations and Iohexol GFR in a subset of 565 patients. The combined uncertainty of using this algorithm was estimated to about 15 % which is about three times that of the S-Creatinine concentration results. The diagnostic performance of S-Creatinine concentration was evaluated using the Iohexol clearance as the reference procedure. It was shown that the diagnostic capacity of MDRD-eGFR, as it stands, has no added value compared to S-Creatinine. The gender and age differences of the S-Creatinine concentrations in the dataset persist after applying the MDRD-eGFR algorithm. Thus, a general use of the MDRD-eGFR does not seem justified. Furthermore the claim that the eGFR is adjusted for body area is misleading; the algorithm does not include any body size marker. It is thus a dangerous marker for guiding drug administration.

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Section: Discussionmentioning

confidence: 99%