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Clinical factors increasing discrepancies of renal function assessment with MDRD and Cockcroft–Gault equations in old individuals
ABSTRACT: In a daily clinical practice, glomerular filtration rate (GFR) is still estimated on the basis of short MDRD formula, whereas medications’ Summaries of Product Characteristics suggest that GFR used for the dosage adjustment should be estimated based on the Cockcroft–Gault (C–G) equation. T...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153700/ https://www.ncbi.nlm.nih.gov/pubmed/30294399 http://dx.doi.org/10.1007/s41999-018-0076-9 |
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author | Chudek, Jerzy Kolonko, Aureliusz Owczarek, Aleksander J. Wieczorowska-Tobis, Katarzyna Broczek, Katarzyna Skalska, Anna Więcek, Andrzej |
author_facet | Chudek, Jerzy Kolonko, Aureliusz Owczarek, Aleksander J. Wieczorowska-Tobis, Katarzyna Broczek, Katarzyna Skalska, Anna Więcek, Andrzej |
author_sort | Chudek, Jerzy |
collection | PubMed |
description | ABSTRACT: In a daily clinical practice, glomerular filtration rate (GFR) is still estimated on the basis of short MDRD formula, whereas medications’ Summaries of Product Characteristics suggest that GFR used for the dosage adjustment should be estimated based on the Cockcroft–Gault (C–G) equation. The aim of the study was to compare eGFR values calculated on the basis of short and full MDRD and C–G equations in PolSenior study participants with decreased eGFR. METHODS: We have assessed differences in the estimation of GFR between short and full MDRD, as well as C–G formula, all equations utilizing non-isotope-dilution mass spectrometry-calibrated measurements of serum creatinine, in the community-based population of 760 persons aged 65 years or above (mean age 82 ± 8 years) with estimated GFR < 60 ml/min/1.73 m(2) (according to short MDRD). In addition, in our analysis, we have included the detailed characteristics of comorbidities and different aspects of mobility and functional performance. RESULTS: The better concordance, precision, and accuracy with MDRD short formula were found for MDRD(full) than C–G equation. In logistic regression analysis, female gender, activities in daily living (ADL) ≤ 4, and age > 80 years diminished, while visceral obesity improved accuracy (P(30)) of eGFR calculated according to C–G equation as compared to MDRD(short). Similar analysis did not found factors influencing P(30) for MDRD(full) equation. CONCLUSIONS: In very old subjects, especially females, dependent patients and those with visceral obesity, estimation of GFR based on short MDRD formula should not be used interchangeably with Cockcroft–Gault equation for the medicines dose tailoring. |
format | Online Article Text |
id | pubmed-6153700 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-61537002018-10-04 Clinical factors increasing discrepancies of renal function assessment with MDRD and Cockcroft–Gault equations in old individuals Chudek, Jerzy Kolonko, Aureliusz Owczarek, Aleksander J. Wieczorowska-Tobis, Katarzyna Broczek, Katarzyna Skalska, Anna Więcek, Andrzej Eur Geriatr Med Research Paper ABSTRACT: In a daily clinical practice, glomerular filtration rate (GFR) is still estimated on the basis of short MDRD formula, whereas medications’ Summaries of Product Characteristics suggest that GFR used for the dosage adjustment should be estimated based on the Cockcroft–Gault (C–G) equation. The aim of the study was to compare eGFR values calculated on the basis of short and full MDRD and C–G equations in PolSenior study participants with decreased eGFR. METHODS: We have assessed differences in the estimation of GFR between short and full MDRD, as well as C–G formula, all equations utilizing non-isotope-dilution mass spectrometry-calibrated measurements of serum creatinine, in the community-based population of 760 persons aged 65 years or above (mean age 82 ± 8 years) with estimated GFR < 60 ml/min/1.73 m(2) (according to short MDRD). In addition, in our analysis, we have included the detailed characteristics of comorbidities and different aspects of mobility and functional performance. RESULTS: The better concordance, precision, and accuracy with MDRD short formula were found for MDRD(full) than C–G equation. In logistic regression analysis, female gender, activities in daily living (ADL) ≤ 4, and age > 80 years diminished, while visceral obesity improved accuracy (P(30)) of eGFR calculated according to C–G equation as compared to MDRD(short). Similar analysis did not found factors influencing P(30) for MDRD(full) equation. CONCLUSIONS: In very old subjects, especially females, dependent patients and those with visceral obesity, estimation of GFR based on short MDRD formula should not be used interchangeably with Cockcroft–Gault equation for the medicines dose tailoring. Springer International Publishing 2018-06-14 2018 /pmc/articles/PMC6153700/ /pubmed/30294399 http://dx.doi.org/10.1007/s41999-018-0076-9 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Paper Chudek, Jerzy Kolonko, Aureliusz Owczarek, Aleksander J. Wieczorowska-Tobis, Katarzyna Broczek, Katarzyna Skalska, Anna Więcek, Andrzej Clinical factors increasing discrepancies of renal function assessment with MDRD and Cockcroft–Gault equations in old individuals |
title | Clinical factors increasing discrepancies of renal function assessment with MDRD and Cockcroft–Gault equations in old individuals |
title_full | Clinical factors increasing discrepancies of renal function assessment with MDRD and Cockcroft–Gault equations in old individuals |
title_fullStr | Clinical factors increasing discrepancies of renal function assessment with MDRD and Cockcroft–Gault equations in old individuals |
title_full_unstemmed | Clinical factors increasing discrepancies of renal function assessment with MDRD and Cockcroft–Gault equations in old individuals |
title_short | Clinical factors increasing discrepancies of renal function assessment with MDRD and Cockcroft–Gault equations in old individuals |
title_sort | clinical factors increasing discrepancies of renal function assessment with mdrd and cockcroft–gault equations in old individuals |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153700/ https://www.ncbi.nlm.nih.gov/pubmed/30294399 http://dx.doi.org/10.1007/s41999-018-0076-9 |
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