title: Comparative performance of four equations estimating glomerular filtration rate in adult Chinese diabetics.
abstract: BACKGROUND
  The Cockcroft-Gault equation, abbreviated Modification of Diet in Renal Disease (MDRD) equation, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and improved abbreviated MDRD equation were used to evaluate renal function in diabetic patients. However, little is known regarding their applicability and precision in Chinese diabetic patients.
  
  
  OBJECTIVE
  To compare the accuracy of four methods evaluating Chinese diabetic patients' renal function.
  
  
  METHODS
  This study included 329 Chinese diabetic patients. Standard GFR (sGFR) was measured via ⁹⁹mTc-DTPA dynamic renal imaging. Estimated GFR (eGFR) was calculated by four equations separately. Applicability of these four equations in Chinese diabetic patients was determined by correlation studies, agreement test, and receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  For Chinese diabetic patients, four methods assessing eGFR correlated well with sGFR. Overall, eGFR calculated via improved abbreviated MDRD had less bias and greater accuracy than the other algorithms estimating GFR (p ≤ 0.01). For patients with sGFR ≥ 60 ml/min/1.73 m², all four equations significantly underestimated actual GFR, with the improved abbreviated MDRD equation best approximating actual GFR (p ≤ 0.01). Conversely, in patients with sGFR<60 ml/min/1.73 m², all four equations overestimated actual GFR; GFR(improved MDRD) was relatively the most accurate (p ≤ 0.01).
  
  
  CONCLUSIONS
  While all four equations were inaccurate, the improved abbreviated MDRD equation best diagnosed and stratified renal failure in Chinese diabetic patients.
authors: Department of Endocrinology, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032 Shaanxi Province, PR China.
authors: Q
authors: Q
authors: Xu
authors: X
authors: X
authors: Li
authors: B
authors: B
authors: Gao
authors: Y
authors: Y
authors: Xu
authors: Y
authors: Y
authors: Wang
authors: N
authors: N
authors: Zhang
authors: W
authors: W
authors: Bond Lau
authors: J
authors: J
authors: Zhou
authors: Q
authors: Q
authors: Ji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002681:China; D015331:Cohort Studies; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D019275:Radiopharmaceuticals; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016284:Technetium Tc 99m Pentetate
chemical_list: D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate