Bedside renal assessment: a comparison of various prediction equations in Thai healthy adults

Area of Science:

• Nephrology
• Clinical Chemistry
• Biomarkers

Background:

• Accurate estimation of glomerular filtration rate (GFR) is crucial for assessing kidney function.
• Existing prediction equations for creatinine clearance (CrCl) and GFR may exhibit ethnic variations in performance.
• Limited data exists on the efficacy of common GFR estimation formulas in healthy Thai adults.

Purpose of the Study:

• To evaluate and compare the performance of established prediction equations for CrCl and GFR estimation.
• To assess these equations specifically within a cohort of healthy Thai adults.

Main Methods:

• Sixty healthy Thai adults underwent comprehensive assessments, including urine analysis and serum creatinine.
• A 24-hour urinary creatinine collection was performed for direct measurement of urine-CrCl.
• The Cockcroft-Gault (CG), MDRD, and Rule equations were employed to estimate GFR and CrCl.

Main Results:

• Measured urine-CrCl averaged 105.3 ± 39.3 ml/min/1.73 m².
• The CG and MDRD equations yielded significantly lower CrCl/GFR estimates compared to measured urine-CrCl.
• A substantial proportion (approximately 60%) of subjects were stratified as having CrCl/GFR < 90 ml/min/1.73 m² by both CG and MDRD equations, indicating potential overestimation of renal impairment.
• Correlation coefficients (R²) between estimated and measured CrCl/GFR were weak, suggesting poor agreement.

Conclusions:

• The Cockcroft-Gault (CG) and MDRD equations demonstrate suboptimal performance for renal function assessment in healthy Thai adults.
• Current prediction equations may not be universally applicable across diverse ethnic groups.
• Further research is warranted to develop and validate more accurate GFR estimation methods tailored for specific populations.