Modified Glomerular Filtration Rate Estimating Equation for Chinese Patients with Chronic Kidney Disease

Abstract

The Modification of Diet in Renal Disease (MDRD) equations provide a rapid method of assessing GFR in patients with chronic kidney disease (CKD). However, previous research indicated that modification of these equations is necessary for application in Chinese patients with CKD. The objective of this study was to modify MDRD equations on the basis of the data from the Chinese CKD population and compare the diagnostic performance of the modified MDRD equations with that of the original MDRD equations across CKD stages in a multicenter, cross-sectional study of GFR estimation from plasma creatinine, demographic data, and clinical characteristics. A total of 684 adult patients with CKD, from nine geographic regions of China were selected. A random sample of 454 of these patients were included in the training sample set, and the remaining 230 patients were included in the testing sample set. With the use of the dual plasma sampling 99m Tc-DTPA plasma clearance method as a reference for GFR measurement, the original MDRD equations were modified by two methods: First, by adding a racial factor for Chinese in the original MDRD equations, and, second, by applying multiple linear regression to the training sample and modifying the coefficient that is associated with each variable in the original MDRD equations and then validating in the testing sample and comparing it with the original MDRD equations. All modified MDRD equations showed significant performance improvement in bias, precision, and accuracy compared with the original MDRD equations, and the percentage of estimated GFR that did not deviate >30% from the reference GFR was >75%. The modified MDRD equations that were based on the Chinese patients with CKD offered significant advantages in different CKD stages and could be applied in clinical practice, at least in Chinese patients with CKD.

Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function

“…Uric acid and the lipid profiles were obtained at fasting the next morning. Estimated glomerular filtration rate was then calculated using the modified glomerular filtration rate estimating equation for Chinese patients 11. Comorbidities were identified by medical history and the associated measures during the index hospitalization.…”

Thrombocytopenia as a Preoperative Risk Assessment Tool in Patients With Rheumatic Heart Disease Undergoing Valve Replacement Surgery

“…Anemic events were defined as hemoglobin levels of <130 g/L in men and <120 g/L in women. The Modification of Diet in Renal Disease equation was used to calculate the estimated glomerular filtration rate, with calibration set to a Chinese patient population 13. Patients with atrial fibrillation (AF) in their medical history and hospital admission physical examination findings were considered as having previous AF.…”

Standards of care for type 2 diabetes in China

“…Diabetic nephropathy is an important type of chronic kidney disease; for diabetic nephropathy patients, the eGFR should be calculated using the Modification of Diet in Renal Disease Study equation or the Cockcroft–Gault formula (Table 5) 74, 75, 76, 77.…”