Comparison of MDRD, CKD-EPI, and Cockcroft-Gault equation in relation to measured glomerular filtration rate among a large cohort with diabetes

作者：Schwandt Anke^*; Denkinger Michael; Fasching Peter; Pfeifer Martin; Wagner Christian; Weiland Joerg; Zeyfang Andrej; Holl Reinhard W

来源：Journal of Diabetes and Its Complications, 2017, 31(9): 1376-1383.

DOI：10.1016/j.jdiacomp.2017.06.016

• Diabetes type 1
• Diabetes type 2
• Glomerular filtration rate (GFR)
• Modification of Diet in Renal Disease (MDRD)
• Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)
• Cockcroft-Gault (CG)

Aims: To analyze the performance of Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Cockcroft-Gault (CG), and CG calculated with ideal bodyweight (CG-IBW) equations to estimate glomerular filtration rate (eGFR) based on serum creatinine in a large diabetic population.
Methods: 24,516 adults with type-1-diabetes or type-2-diabetes from the multicenter diabetes prospective follow-up registry DPV were analyzed. We compared eGFR and measured GFR (mGFR) based on 24-h urine collection by calculating mean bias (difference), precision (SD of this difference), accuracy (proportion of eGFR within +/- 10% of mGFR), Bland-Altman-plots.
Results: CG overestimates, whereas MDRD, CKD-EPI, and CG-IBW underestimate. Smallest mean bias and highest accuracy (753%) were observed for MDRD compared to the other equations (p < 0.0001). MDRD and CID-EPI estimated most accurately in stages 1 (MDRD:57.7%, CKD-EPI:57.3%) and 2 (MDRD:80.2%, CKD-EPI:80.7%). In stages 3 to 5, highest accuracy was observed for the MDRD (stage 3:823%, stage 4:77.8%, stage 5:71.0%). Among younger subjects, accuracy was higher using the CKD-EP1 (18-<40 years:63.7%, 40-<60 years:72.8%). Above age 60 years, MDRD estimated most accurately (60-<70 years:77.3%, >= 70 years:78.8%). In males and females, MDRD estimated most accurately (males:75.3%, females:753%).
Conclusion: In this large diabetic cohort, smallest bias and highest accuracy were observed for the MDRD.

• 出版日期2017-9