Accuracy of Various Creatinine Based Prediction Equations For Estimating Glomerular Filtration Rate in Prospective Donors in Comparison to DTPA Renogram.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Objectives: A noninvasive and accurate estimation of GFR is one of the holy grails of renal function evaluation. We analysed accuracy of CKD Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD) and Mayo Clinic Quadratic (MCQ) equations to estimate GFR with reference to a standard GFR obtained by DTPA renal scan. Methods: Between June 2011 and June 2013, healthy adults underwent DTPA renal clearance studies as part of a routine work-up for potential kidney donation. 70 subjects had sufficient data to estimate GFR- including age, gender, Creatinine (Cr){based on average of 2 values obtained 2 weeks apart performed at the same hospital lab}. Results: Mean GFR obtained by DTPA, CKD-EPI, MDRD and MCQ were 93.4±13.4, 86.94±14.8, 83.0±17.6 and 104.5±10.27ml/min/1.73m2 respectively. All equations correlated well with DTPA-GFR (p< 0.01). The bias and mean absolute difference in ml/min per 1.73 m2 between calculated and measured GFR for CKD-EPI, MDRD, MCQ were -6.57 and 11.03, -10.45 and 14.75, +11.1 and 14.13 respectively. Percentage of values within 30% and 50% of predicted in each equations were - CKD-EPI: 71.4%; 91.4%, MDRD: 51.4%; 81.4%, MCQ: 57.1%; 81.4%. Conclusion: CKD-EPI had least bias and was more accurate within 30 and 50% of the measured GFR even though it frequently under estimated measured GFR. MCQ equation (developed for patients with preserved renal function) had least bias in subset of measured GFR>90ml/min. In potential donors, these equations may not be sufficient for estimating GFR. Further studies are needed to derive prediction equations in Indians with normal renal function.
Authors and Affiliations
Dr Dineshan KM, Dr Aditya Shenoy, Dr Felix Cardoza
Keywords
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- EP ID EP592488
- DOI 10.9790/0853-1603020106
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