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Correlation of eGFR By MDRD and CKD-EPI Formula with Creatinine Clearance Estimation in CKD Patients and Healthy
S K Das1, D K Roy, A A Chowdhury
1Dr Samir Kumar Das, Assistant Professor, Department of Nephrology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh;
Insights
This study compared estimated glomerular filtration rate (eGFR) formulas in Chronic Kidney Disease (CKD) patients and healthy individuals. The CKD-EPI formula showed a stronger correlation with 24-hour creatinine clearance than the MDRD formula.
Area of Science:
- Nephrology
- Clinical Chemistry
- Biostatistics
Background:
- Chronic Kidney Disease (CKD) diagnosis and staging rely heavily on accurate estimation of glomerular filtration rate (GFR).
- Various formulas exist to estimate GFR (eGFR) using serum creatinine, but their performance can vary between patient populations.
- Comparing the performance of commonly used eGFR equations is crucial for clinical decision-making.
Purpose of the Study:
- To compare the accuracy of the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation and the MDRD (Modification of Diet in Renal Disease) study equation in estimating GFR.
- To assess the correlation of these eGFR formulas with measured 24-hour creatinine clearance (CCCR) in both CKD patients and healthy subjects.
Main Methods:
- A cross-sectional comparative study involving 100 CKD patients and 100 healthy controls.
- Data collection included patient interviews, clinical examinations, and laboratory investigations.
- GFR was estimated using CKD-EPI and MDRD formulas and compared with 24-hour creatinine clearance (CCCR).
Main Results:
- Both CKD-EPI and MDRD formulas showed statistically significant differences in all variables compared to healthy subjects (p<0.001).
- Strong positive correlations were observed between CCCR and CKD-EPI (r=0.934) and MDRD (r=0.913) across all subjects.
- CKD-EPI demonstrated a slightly better correlation with CCCR (r=0.848) compared to MDRD (r=0.841) specifically in CKD patients.
Conclusions:
- The CKD-EPI equation exhibits a fairly good correlation with 24-hour creatinine clearance in both CKD patients and healthy individuals.
- The CKD-EPI equation appears to be more accurate than the MDRD equation for estimating eGFR in this study population.
- Accurate eGFR estimation is vital for managing CKD and ensuring appropriate patient care.
Abstract:
This cross sectional comparative study was conducted in the Nephrology and Medicine outdoor and in-patients department of Mymensingh Medical College Hospital, Bangladesh from April 2014 to March 2015. A total of 100 patients with CKD and 100 healthy subjects were included in the study. Data were collected by interview of the patients, clinical examination and laboratory investigations using a semi-structured case record form. Among all subjects, 50.0% had no CKD and 50.0% patients had CKD: Stage 3 CKD were 8.5%, CKD Stage 4 CKD were 21.0%, CKD Stage 5 CKD were 20.5%. Serum creatinine was 4.32±3.08mg/dl in patients with CKD and 1.00±0.22mg/dl was in healthy subjects. Mean±SD of CCR/ml/min was found 17.67±11.63ml/min in patients with CKD and 79.31±13.31ml/min was found in healthy subjects. On the other hand, Mean±SD CCCR/ml/m/1.73m² was found 19.79±12.85 ml/m/1.73m² in patient with CKD and healthy subjects had 83.83±13.33 ml/m/1.73m². Urinary creatinine was 45.59±15.63 & 57.66±11.45mg/dl respectively. CKD-EPI eGFR was 22.10±15.02 & 90.61±23.27ml/m/1.73m²; MDRD eGFR was 22.15±14.18 & 89.35±26.19 ml/m/1.73m² respectively. Difference between all the variables between CKD group and healthy group was found statistically significant (p<0.001). CKD-EPIeGFR and MDRDeGFR were increased both in CKD patients and healthy subjects in respect to CCR and CCCR. There was a strong positive correlation between CCCR (ml/m/1.73m2) and CKD-EPI (ml/m/1.73m²) among all patients (r=0.934 and p<0.001) and also a positive correlation of CCCR with MDRD among all patients (r=0.913 and p<0.001). A positive correlation of CCCR was found with CKD-EPIeGFR among CKD patients (r=0.848 and p<0.001). A positive correlation of CCCR was also found with MDRDeGFR among CKD patients (r=0.841, p<0.001). There are positive correlations between CCCR and CKD/EPI among healthy subjects (r=0.616 and p<0.05) and between CCCR with MDRD among healthy subjects (r=0.568 and p<0.05). Various formulae were used to calculate GFR on the basis of serum creatinine levels. The Overall correlation of population (healthy and CKD patients) between CCCR and CKD EPI and MDRD formula was (r=0.93 and 0.91) respectively, among CKD patients it was (r=0.848 and r=0.841) in healthy subjects it was (r=0.616 and r=0.568) respectively. CKD EPI eGFR and MDRD eGFR formula had fairly good correlation with conventional 24 hours creatinine clearance in both CKD patient and healthy subjects, there was even more strong correlation especially in CKD patients. The performance of CKD-EPI equation is better than MDRD equation to estimate the eGFR in both CKD patients and healthy subjects.
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