Abstract
Glomerular filtration rate (GFR) is the most important and accurate measure of overall kidney functions both in good health and disease because it is the sum of the filtration rates in each of the functioning nephrons .Different GFR measuring methods have some limitations.The objective of this study was to compare the CKD-EPI formula based eGFR with that of Cock- croft- Gault formula & 4 variable MDRD formula based eGFR.This Cross-sectional analytical study was done in the Department of Biochemistry & Molecular biology, BSMMU September during the period of July 2017 to August 2018. Serum creatinine was measured and eGFR by MDRD, CKD-EPI and Cockcroft-Gault formula was calculated using the respective equations on online calculator. Comparison of eGFR values between CKD-EPI & MDRD formula and between CKD-EPI & Cockcroft-Gault formula were done among different groups. Compari- son was done by Bland Altman agreement test to see the agreement on the measurement of GFR between three equation based eGFR method. Pearson‘s correlation test revealed a positive correlation between C-G and CKD-EPI (r = 0.779), but a stronger correlation between MDRD and CKD-EPI (r = 0.934). Bland-Altman plot showed strong agreement between CKD-EPI & 4–variable MDRD than between CKD-EPI & C-G formula. From this study we may conclude CKD-EPI and MDRD formula showed better agreement than between CKD-EPI and Cockcroft-Gault formula. So, this study suggests that CKD-EPI and MDRD equations can be used to estimate GFR more effectively than Cockcroft-Gault equation in Bangladeshi population. BSMMU J 2021; 14(4): 152-156
Highlights
Chronic kidney disease is defined as either the presence of kidney damage or glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 for three or more months.[1]
Serum creatinine and eGFR were measured in the Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University (BSMMU). eGFR was calculated by modification of diet in renal disease (MDRD) formula in the Department of Biochemistry and Molecular Biology, BSMMU. eGFR by chronic kidney disease (CKD)-EPI formula and Cockcroft-Gault formula was calculated by using the respective equations on online calculator
Comparison of eGFR values between CKD-EPI & MDRD formula and between CKD-EPI & Cockcroft-Gault formula were done among different groups
Summary
Chronic kidney disease is defined as either the presence of kidney damage or GFR less than 60 mL/min/1.73 m2 for three or more months.[1]. National Kidney Foundation recommended estimation of GFR is essential for monitoring of chronic kidney disease (CKD) or to detect CKD among those with risk factors.[2]. The National Kidney Disease Education Program recommends calculating glomerular filtration rate (GFR) from serum creatinine based predictive equations.[5]. The urinary or plasma clearance of an ideal filtration marker, such as inulin and Technetium-99m DTPA is the gold standard for the measurement of GFR.[6]. They are time consuming, expensive and troublesome than e GFR by prediction equation. The CKD-EPI equation is based on the same four variables as the MDRD Study equation, but uses a 2-slope spline to model the relationship between estimated GFR and serum creatinine, and a different relationship for age, sex and race.[8]
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