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The reliability of different formulae to predict creatinine clearance
J C Verhave1, C P Baljé-Volkers, H L Hillege
1Department of Medicine, Division of Nephrology, University Medical Center Groningen, Groningen University The Netherlands.
Journal of Internal Medicine
|April 19, 2003
Summary
Estimating creatinine clearance (CCR) using formulas is convenient but often inaccurate, especially for men and obese individuals. Formulas provide a fair overall estimate but lack precision in extreme ranges and for age-related decline.
Area of Science:
- Nephrology
- Clinical Chemistry
- Epidemiology
Background:
- Creatinine clearance (CCR) is a standard measure of glomerular filtration rate (GFR).
- 24-hour urine collection for CCR measurement is inconvenient for patients.
- Various formulas estimate GFR using plasma creatinine and biometrical data.
Purpose of the Study:
- To evaluate the accuracy of 10 different formulas for estimating CCR.
- To compare formula-based GFR estimates with measured CCR in a large general population sample.
Main Methods:
- Cross-sectional cohort study design.
- Inclusion of 8592 inhabitants (28-75 years) from Groningen, enriched for microalbuminuria.
- Comparison of 10 estimation formulas against measured CCR.
Main Results:
- Formulas generally showed inaccurate CCR estimations, particularly in males and obese subjects.
- Six formulas, including Cockcroft-Gault, provided fair overall CCR estimates.
- All formulas underestimated CCR at higher ranges and overestimated at lower ranges.
- Age-related decline in CCR was poorly approximated by the formulas.
Conclusions:
- Formula-based CCR estimates are not reliable for upper and lower ranges in the general population.
- These formulas do not adequately capture the age-related decline in CCR.
- While convenient, formula estimations should be interpreted with caution due to accuracy limitations.