PT  - JOURNAL ARTICLE
AU  - Botev, Rossini
AU  - Mallié, Jean-Pierre
AU  - Couchoud, Cecilé
AU  - Schück, Otto
AU  - Fauvel, Jean-Pierre
AU  - Wetzels, Jack F.M.
AU  - Lee, Nelson
AU  - De Santo, Natale G.
AU  - Cirillo, Massimo
TI  - Estimating Glomerular Filtration Rate: Cockcroft–Gault and Modification of Diet in Renal Disease Formulas Compared to Renal Inulin Clearance
AID  - 10.2215/CJN.05371008
DP  - 2009 May 01
TA  - Clinical Journal of the American Society of Nephrology
PG  - 899--906
VI  - 4
IP  - 5
4099  - http://cjasn.asnjournals.org/content/4/5/899.short
4100  - http://cjasn.asnjournals.org/content/4/5/899.full
SO  - CLIN J AM SOC NEPHROL2009 May 01; 4
AB  - Background and objectives: Evaluation of renal function by estimation of the glomerular filtration rate (GFR) is very important for the diagnosis and treatment of patients with chronic kidney disease (CKD). The Cockcroft–Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulas are the most commonly used estimations.Design, setting, participants, & measurements: Estimated GFR values by each formula were compared with measured GFR (mGFR) by renal inulin clearance in 2208 European adults (46% women, 1.4% Caribbean blacks), with and without CKD, and mean mGFR 72.4 ± 39.0 (range 2.2 to 177.2) ml/min/1.73 m2.Results: Overall, the CG and MDRD formulas showed bias (mean difference) −3.5 ml/min/1.73 m2 (5.3%), P < 0.001, and −9.8 ml/min/1.73 m2 (−6.4%), P < 0.001; precision (SD of bias) 21.5 ml/min/1.73 m2 (43.1%) and 20.0 ml/min/1.73 m2 (33.0%); limits of agreement (2 SD by Bland–Altman method) 39.5 to −46.5 (range 86.0) ml/min/1.73 m2 and 30.2 to −49.8 (range 80.0) ml/min/1.73 m2; and accuracy within ±30% of mGFR 70.8 and 69.0%, respectively. Both formulas showed a trend for decreasing accuracy with lower mGFR levels. According to the Kidney Disease Outcomes Quality Initiative (K/DOQI)-CKD classification's five GFR groups, the CG and MDRD formulas properly assigned 61.6 and 57.1% of the entire population and had a range of positive predictive values 42.6 to 81.8% and 39.6 to 85.2% and of negative predictive values 81.7 to 96.6% and 76.4 to 97.5%, respectively.Conclusions: The CG and MDRD formulas had some limitations for proper GFR estimation and K/DOQI-CKD classification by GFR levels alone.