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Kidney Week

Abstract: PO2253

Comparison of Creatinine-Based Estimated Glomerular Filtration Rate Equations with DTPA GFR in Healthy Adults

Session Information

Category: Pathology and Lab Medicine

  • 1602 Pathology and Lab Medicine: Clinical

Authors

  • Bandi, Varun kumar, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & RF, Vijayawada, Andhra Pradesh, India
  • Ramineni, Spoorthi, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & RF, Vijayawada, Andhra Pradesh, India
Background

Measurement of Glomerular filtration rate (GFR) is a reliable technique but is expensive and cumbersome for routine use. GFR is routinely estimated (eGFR) with serum creatinine. These equations are not widely validated in Indian population.

Methods

The cross-sectional study was done on live kidney donors. DTPA was used to measure GFR, 24 hour creatinine clearance (CrCl) was measured and creatinine based eGFR was calculated using Cockcroft-Gault (CG), Modification of Diet in Renal Disease- fourvariable (MDRD-4), Modification of Diet in Renal Diseasesix-variable(MDRD-6), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations

Results

88 subjects were included,of whom 29.5% were male, with a mean age of 46.8 yrs, and BMI of 25.7 kg/m2. Mean GFR (± standard deviation) obtained by CKD-EPI, MDRD-4, MDRD-6, CG, CrCl, and DTPA GFR were 99.8 (±15.2), 96.2 (±17.9), 106.1 (±20.2), 88.3(±38.7), 89.3(±29.2) and 93.6(±11) ml/min/1.73m2respectively.The mean absolute difference in GFR and percentage variation between calculated and measured GFR for CKD-EPI, MDRD-4, MDRD-6, CG, CrCl were 14.7 (16.5%), 16.2 (17.9%), 19.8 (22.2%), 33.2 (36.5%), and 23.6(25.7%) respectively. Percentage of valueswithin 20%of DTPA GFR in each equations were CKD-EPI - 69.32%, MDRD-4 – 70.45%, MDRD-6 -54.55%, CG- 38.64%, and CrCl- 45.45%. There was no significant co-relation between the measured GFRs and eGFR using any of the above equations.

Conclusion

All the equations used (CKD-EPI, MDRD4, MDRD6, CG) and CrCl did not correlate significantly with the measured GFR. Among the equations, CKD-EPI had the least variation with about 69% confirming within 20% of DTPA GFR, and about 86% and 97% confirming within 30% and 50% of DTPA GFR.

Table 1: Percentage of eGFR estimations ocurring within 20 %, 30 % , and 50% variation of DTPA GFR values
Equation20% of GFR30% of GFR50% of GFR
EPI69.32%86.36%96.59%
MDRD470.45%82.95%95.45%
MDRD654.55%72.73%93.18%
CG38.64%53.41%62.50%
CrCl45.45%68.18%90.91%