Time to change the glomerular filtration rate estimating formula in primary care?

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• 作者：P&auml ; ivi E. Korhonen^a ; ^b ; ^{paivi.e.korhonen@fimnet.fi} ; Hannu Kautiainen^c ; ^d ; Salme J&auml ; rvenp&auml ; &auml ; ^e ; Sirkka-Liisa Kivel&auml ; ^f ; ^g ; ^h
• 关键词：Renal function ; Cardiovascular risk factors ; Glucose homeostasis ; Primary care
• 刊名：European Journal of Internal Medicine
• 出版年：2012
• 期刊代码：91_09536205
• 类别：med
• 出版时间：June, 2012
• 卷：23
• 期：4
• 页码：355-357
• 文件大小：141 K

摘要

Background

The most commonly used equation for estimated glomerular filtration rate (eGFR) is nowadays the four-variable Modification of Diet in Renal Disease (MDRD) equation. This formula was derived from patients with non-diabetic chronic kidney disease (CKD) with mean GFR 40 ml/min.

Methods

We compared the MDRD study equation and the recently developed Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation by applying the two formulas in 1747 middle-aged cardiovascular risk persons in primary care.

Results

The prevalence of renal insufficiency defined as eGFR < 60 ml/min was 6.7%(95%CI 5.6-8.0) according to the MDRD formula, and 3.6%(95%CI 2.8-4.6) according to the CKD-EPI formula. The subjects who were classified as having CKD according to the MDRD equation, but no-CKD according to the CKD-EPI formula, were mostly women (86%) and slightly younger than the subjects having CKD according to both formulas.

Conclusion

The characteristics of the subjects commonly treated in primary care resemble more closely the population from which the CKD-EPI than the MDRD study equation was derived from. Thus, we suppose that in general practice, the CKD-EPI equation is more suitable for estimating renal function than the MDRD equation.