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Related Experiment Videos

Difference in estimated GFR with two different formulas in elderly individuals.

K Wieczorowska-Tobis1, Z I Niemir, P Guzik

  • 1Department of Pathophysiology, University of Medical Sciences, 60-781, Poznan, Poland. kwt@tobis.pl

International Urology and Nephrology
|July 27, 2006
PubMed
Summary

The Modification of Diet in Renal Diseases (MDRD) formula estimates higher glomerular filtration rates (GFR) in elderly individuals compared to the Cockcroft-Gault (CG) formula. These differences in GFR prediction are significantly influenced by age, BMI, and serum creatinine levels.

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Area of Science:

  • Nephrology
  • Geriatrics
  • Clinical Chemistry

Background:

  • Glomerular filtration rate (GFR) is a key indicator of kidney function.
  • Accurate GFR estimation is crucial for managing elderly patients with chronic kidney disease.
  • Existing GFR estimation formulas may have differential performance in specific populations, such as the elderly.

Purpose of the Study:

  • To compare GFR estimations between the Cockcroft-Gault (CG) formula and the Modification of Diet in Renal Diseases (MDRD) formula in elderly subjects.
  • To identify the determinants of the differences between MDRD and CG GFR estimations in this population.

Main Methods:

  • Cross-sectional study involving 100 elderly individuals (aged 65-111 years).
  • GFR was calculated using both the CG and MDRD formulas.

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  • Statistical analysis, including multiple linear regression, was used to analyze the difference (MDRD-CG) and its correlation with demographic and clinical factors.

    • Main Results:

    • Mean GFR was significantly higher when estimated by MDRD (76.0±24.0 ml/min/1.73 m²) compared to CG (67.9±18.6 ml/min/1.73 m²).
    • The difference (MDRD-CG) averaged 30.0±26.6 ml/min/1.73 m², indicating substantially higher MDRD values.
    • MDRD-CG differences were strongly dependent on age (p<0.0001), BMI (p<0.0001), and serum creatinine (p<0.0001), but not gender.

    Conclusions:

    • The MDRD formula provides significantly higher GFR estimates than the CG formula in the elderly.
    • Age, BMI, and serum creatinine are critical factors influencing the discrepancy between MDRD and CG GFR estimations in older adults.
    • Clinicians should consider these formula-specific differences when interpreting GFR in elderly patients.