Summary:
Many organizations recommend the use of equations that
provide a rapid method of assessing glomerular filtration
rate (GFR) to facilitate the detection, evaluation, and
management of chronic kidney diseases. Indeed, many
clinical laboratories already report estimated GFR (eGFR)
values whenever the serum creatinine level is measured. To
compare the predictive equations for the measurement of
GFR in Bangladeshi population, we measured GFR by
creatinine clearance rate (CCR) and also estimated it by
Modification of Diet in Renal Disease (MDRD) 4 variables
equation and Cockcroft and Gault (C-G) formula in 61
Bangladeshi subjects who were referred to Armed Forces
Institute of Pathology, Dhaka Cantonment for the estimation
of GFR by physicians during the period of March 2011 to
November 2011. Results are expressed as mean ± SD and
compared by two-tailed paired t test, Bland-Altman plots for
bias, precision (r2), receiver-operating characteristics (ROC)
curve, and accuracy within 15%, 30% and 50% of the
measured GFR. We included 39 (63.93%) males and 22
(36.06%) females with mean age of 52±14 years. The GFR
measured by CCR was 61.30±37.38 mL/min/1.73 m2 and
eGFR by MDRD4 and C-G were 51.26±26.86 (P<0.05),
54.98±27.21 (P>0.05) mL/min/1.73 m2 respectively. The bias
was “10.55±25.34 mL/min/1.73 m2 for MDRD, “6.32±25.90
mL/min/1.73 m2 for C-G; precision was 0.5407 for MDRD,
0.5201 for C-G; the areas under the ROC curve was 0.5722
(P>0.05) for MDRD4, 0.5444 (P>0.05) for C-G. The
percentages of eGFR falling within 15% and 30% of
measured GFR were 30%, 52% for MDRD and 35%, 52%
for C-G. Both MDRD4 and C-G showed positive bias at
GFR<60 mL/min/1.73 m2 and negative bias at GFR >60
mL/min/1.73 m2. The results indicate that Cockcroft-Gault
formula is more accurate than MDRD4 equation in the
overall GFR range, but MDRD4 appears to be more accurate
at GFR <60 mL/min/1.73 m2.
Key words: CCR, MDRD, Cockcroft-Gault formula,
Estimated GFR, eGFR in Bangladeshi population.
(J Banagladesh Coll Phys Surg 2015; 33: 207-212)