Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease.
The Modification of Diet in Renal Disease (MDRD) equations provide a rapid method of assessing GFR in patients with chronic kidney disease (CKD). However, previous research indicated that modification of these equations is necessary for application in Chinese patients with CKD. The objective of this study was to modify MDRD equations on the basis of the data from the Chinese CKD population and compare the diagnostic performance of the modified MDRD equations with that of the original MDRD equations across CKD stages in a multicenter, cross-sectional study of GFR estimation from plasma creatinine, demographic data, and clinical characteristics. A total of 684 adult patients with CKD, from nine geographic regions of China were selected. A random sample of 454 of these patients were included in the training sample set, and the remaining 230 patients were included in the testing sample set. With the use of the dual plasma sampling (99m)Tc-DTPA plasma clearance method as a reference for GFR measurement, the original MDRD equations were modified by two methods: First, by adding a racial factor for Chinese in the original MDRD equations, and, second, by applying multiple linear regression to the training sample and modifying the coefficient that is associated with each variable in the original MDRD equations and then validating in the testing sample and comparing it with the original MDRD equations. All modified MDRD equations showed significant performance improvement in bias, precision, and accuracy compared with the original MDRD equations, and the percentage of estimated GFR that did not deviate >30% from the reference GFR was >75%. The modified MDRD equations that were based on the Chinese patients with CKD offered significant advantages in different CKD stages and could be applied in clinical practice, at least in Chinese patients with CKD.
Ma
Ying-Chun
YC
Division of Nephrology and Institute of Nephrology, The First Hospital, Peking University, No. 8 Xishiku Street, Xicheng District, Beijing 100034, PR China.
Zuo
Li
L
Chen
Jiang-Hua
JH
Luo
Qiong
Q
Yu
Xue-Qing
XQ
Li
Ying
Y
Xu
Jin-Sheng
JS
Huang
Song-Min
SM
Wang
Li-Ning
LN
Huang
Wen
W
Wang
Mei
M
Xu
Guo-Bin
GB
Wang
Hai-Yan
HY
D000465:Algorithms; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003710:Demography; D004032:Diet; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D016284:Technetium Tc 99m Pentetate
D003404:Creatinine; D016284:Technetium Tc 99m Pentetate