Abstract
Objective: To compare the performance of Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) equations in estimating kidney function in CKD patients with diabetes and hypertension.
 Methods: This study retrospectively reviewed medical records in Hospital Kajang. The GFR was calculated using Cockcroft-Gault and MDRD equations. Kappa Measure of Agreement was used to check the consistency of CKD staging. Wilcoxon signed-ranked tests and Bland-Altman plots were used to determine the difference of both equations. Spearman correlation was used to determine the correlation between blood pressure and blood sugar levels with eGFR.
 Results: Data pertaining to a total of 81 patients were extracted. Results showed 22% of the patients were staged differently (Kappa value = 0.644 [P<0.001]) and the majority of them moved down one CKD stage when MDRD equation was used instead of Cockcroft-Gault equation. Wilcoxon signed rank test demonstrated there was a significant difference (P<0.001) in eGFR using CandG and MDRD in patients with diabetes and hypertension. Furthermore, the mean difference observed was 3.78±5.56 [P<0.001]), where the Cockcroft-Gault equation measured 3.78 units higher than MDRD equation. However, the relationship between blood sugar and blood pressure with eGFR were not significant.
 Conclusion: There was a significant difference between Cockcroft-Gault and MDRD equations in estimating kidney function CKD patients with diabetes and hypertension.
Highlights
Chronic kidney disease (CKD) was ranked the 18th cause of global deaths [1]
A total of 81 CKD patients were reviewed with a mean age of 60.39±10.72 y, with 46 % of patients aged over 60 y
The Estimated GFR (eGFR) measured by Cockcroft-Gault was higher than eGFR measured by Modification of Diet in Renal Disease (MDRD)
Summary
Chronic kidney disease (CKD) was ranked the 18th cause of global deaths [1]. The overall prevalence of CKD in West Malaysia was 9.07 % [2]. Progression of CKD to end-stage renal disease (ESRD) increases the burden of healthcare budgets of the country [3]. The main important risk factors of CKD are diabetes (DM) and hypertension (HTN) [4]. CKD patients are often asymptomatic and the abnormalities were clinically manifested at very late stage [5]. Patients with DM and/or HTN are advised be screened at least yearly for CKD because early detection and intervention of these high-risk groups may prevent the development and progression of CKD [6]
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