Vnitr Lek 2008, 54(4):346-351

Possibilities of evaluation of changes of glomerular filtration rate estimated on the basis of predicting formulas

O. Schück1,*, M. Horáčková1, V. Teplan2, M. Štollová2
1 Interní klinika 2. lékařské fakulty UK a FN Motol Praha, přednosta prof. MUDr. Milan Kvapil, CSc.
2 Klinika nefrologie transplantačního centra IKEM Praha, přednosta prof. MUDr. Vladimír Teplan, DrSc.

Introduction:
Estimation of changes of glomerular filtration rate based on accurate measurement (GFR) and that based on predicting formulas (eGFR) could differ significantly. In this study we have tried to analyse the relationship between (eGFR)t2 / (eGFR)t1 and (GFR)t2 / (GFR)t1 (where t1 and t2 denote the time at the beginning and the end of the follow-up interval).

Methods:
Renal clearance of inulin (Cin) was repeatedly examined in 32 patients suffering from chronic renal impairment (SCr = 231 ± 70 μmol/l). Estimated GFR (eGFR) was calculated on the basis of Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault (CG) equations.

Results:
A significant relationship between (MDRD)t2 / (MDRD)t1 and (Cin)t2 / (Cin)t1 (r = 0.544, p = 0.0028, R2 = 0.295) as well as between (CG)t2 / (CG)t1 and (Cin)t2 / (CG)t1 (r = 0.556, p = 0.0026, R2 = 0.309) was found. Average difference between (MDRD)t2 / (MDRD)t1 - (Cin)t2 / (Cin)t1 was 0.017 ± 0.17 and that of (CG)t2 / (CG)t1 - (Cin)t2 / (Cin)t1 was 0.024 ± 0,18. Within ± 0.20 of the difference (eGFR)t2 / (eGFR)t1 - (Cin)t2 / (Cin)t1 59 % values were found and within ± 0.30 of this difference 75 % values were recorded. Highly significant relationship was found between (MDRD)t2 / (MDRD)t1 and (CG)t2 / (CG)t1 (r = 0.991; p = 0.0001; R2 = 0.983).

Conclusion:
Considering these preliminary findings, predicting formulas are not sensitive sufficiently to by able to detect GFR changes lower than 30 % of initial value.

Keywords: formulas predicting GFR; evaluation of GFR changes; MDRD; Cockcroft-Gault equation

Received: December 3, 2007; Accepted: February 7, 2008; Published: April 1, 2008  Show citation

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Schück O, Horáčková M, Teplan V, Štollová M. Possibilities of evaluation of changes of glomerular filtration rate estimated on the basis of predicting formulas. Vnitr Lek. 2008;54(4):346-351.
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    References

    1. Shemesh O, Golbertz H, Kriss J et al. Limitations of creatinine clearance as a filtration marker of glomerulopathic patients. Kidney Int 1985; 28: 830-838. Go to original source... Go to PubMed...
    2. Levey AS, Bosch JP, Lewis JB et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med 1999; 130: 461-470. Go to original source... Go to PubMed...
    3. Cockcroft DV, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: 31-41. Go to original source... Go to PubMed...
    4. Grubb A, Nyman U, Björk Y et al. Simple cystain C based prediction equation of glomerular filtration rate compared with the modification of diet in renal diseases prediction equation for adults and the Schwartz and Couiham-Barratt prediction equation for children. Clin Chem 2005; 51: 1420-1431. Go to original source... Go to PubMed...
    5. Kempermann FAV, Krediet RT, Arizs L. Formula-derived prediction of glomerular filtration rate from plasma creatinine concentration. Nephron 2002; 91: 574-558. Go to original source... Go to PubMed...
    6. Schück O, Teplan V, Smrčková I et al. Sérová koncentrace kreatininu a fuknce ledvin (nový vhled do staré problematiky). Vnitř Lék 2005; 51: 725-727.
    7. Jabor A, Straka L, Lukášová J. Odhad glomerulární filtrace. FONS 2006; 3-4: 41-43.
    8. Kubáč P, Benyška J. Zkušenosti s diagnostikou renálních funkcí v Městské nemocnici Ostrava. FONS 2007; 2: 31-37.
    9. Tesař V, Schück O et al. Klinická nefrologie. Praha: Grada Publishing 2006.
    10. DuBois D, DuBois EF A. formula to estimate the approximate surface area if hight and weight be known. Arch Intern Med 1916; 17: 863-971. Go to original source...
    11. Schück O, Horáčková M. Relationship between serum creatinine increase or serum creatinine doubling and decrease of glomerular filtration rate estimated by predicting formulas. Int J Clin Pharmacol Ther 2007; 46: 40-41. Go to original source... Go to PubMed...
    12. White RP, Samson FE. Determination of inulin by use of a throne. J Lab Clin Med 1954; 43: 475-478.
    13. Lin J, Knight EL, Hogan ML et al. A comparison of prediction equations for estimating glomerular filtration rate in adults without kidney disease. J Am Soc. Nephrol 2003; 14: 2580-2003. Go to original source... Go to PubMed...
    14. Rule AD, Gussak HM, Pond GR et al. Measured and estimated GFR in healthy potential kidney donors. Transplantation 2004; 43: 112-113. Go to original source...
    15. Mariat Ch, Almartine E, Barhelemy JC et al. Assessing renal graft function in clinical trials: Can be tests predicting glomerular filtration rate substitute for a reference Method. Kidney Int 2004; 65: 289-297. Go to original source... Go to PubMed...
    16. Saracine A, Morrone LF, Suriano V et al. A simple method for correcting overestimated filtration rate in obese subjects evaluated by Cockcroft and Gault formula: a comparison with 51Cr EDTA clearance. Clin Nephrol 2001; 53: 1255-1261.
    17. Van de Ree MA, Christian G, Huisman MV et al. Monitoring renal function in obese patients with type 2 diabetes mellitus in daily practice. Diab Nutr Metab 2001; 14: 66-70. Go to original source...
    18. Verhave JC, Fesler P, Ribenstein J et al. Estimation of renal function in subjects with normal serum creatinine levels: influence of age and body mass index. Am J Kidney Dis 2005; 46: 233-241. Go to original source... Go to PubMed...
    19. Schück O, Teplan V, Skibová J et al. Možnosti posouzení glomerulární filtrace na podkladě preduikčních formulí u obézních jedinců s chronickým renálním omezením. Čas Lék čes 2006; 145: 722-776.
    20. Stevens LA, Coresh J, Greene T et al. Assessing kidney function - measured and estimated glomerular filtration rate. N Engl J Med 2006; 354: 2473-2483. Go to original source... Go to PubMed...

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