Relationship of gender, age, and body mass index to errors in predicted kidney function.
BACKGROUND
Previous studies have shown conflicting data on accuracy of equations for kidney function prediction. The present work analysed the relationship of gender, age and body mass index (BMI) to error of predictions by the Cockcroft-Gault equation (CG(eq)), the simplified equation of the Modification of Renal Diseases Study (MDRD(eq)) and the Mayo Clinic equation (Mayo(eq)).


METHODS
Inulin clearance (glomerular filtration rate; GFR) and other variables were measured in 380 subjects of both sexes, aged 18-88 years, with and without kidney disease. GFR was defined as low when <60 ml/min x 1.73 m2. BMI was used for definition of underweight/overweight. Relative error of predictions was used as an index of bias. It was calculated as prediction minus GFR (positive values =overestimates, negative values = underestimates) and expressed as a percentage of the GFR. Absolute error was used as an index of imprecision and was calculated as the absolute value of relative error.


RESULTS
CG(eq) relative error was inversely associated with age and directly associated with BMI (P<0.001), but not with gender or GFR. MDRD(eq) relative error was inversely associated with female gender and GFR (P<0.001), but not with age or BMI. Mayo(eq) relative error was directly associated with male gender, BMI and GFR (P<0.01), but not with age. Absolute error was higher for CG(eq) than for MDRD(eq) but only at low GFR (P<0.001). Mayo(eq) had a higher absolute error than CG(eq) and MDRD(eq) (P<0.01).


CONCLUSIONS
Errors of predictions varied not only with GFR but also with gender, age and BMI. Without using creatinine assay calibration, Mayo(eq) was less accurate than both MDRD(eq) and CG(eq), whereas MDRD(eq) was slightly more precise than CG(eq) but only at low GFR.
Nephrology, Second University of Naples, Naples, Italy. massimo.cirillo@unina2.it
Massimo
M
Cirillo
Pietro
P
Anastasio
Natale G
NG
De Santo
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000254:growth & development / Q000502:physiology*; D007674:Kidney Diseases / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012727:Sex Characteristics