title: Comparison of abbreviated modification of diet in renal disease formula (aMDRD) and the Cockroft-Gault adjusted for body surface (aCG) equations in stable renal transplant patients and living kidney donors.
abstract: The performance of abbreviated modification of diet in renal disease formula (aMDRD) and the Cockroft-Gault adjusted for body surface (aCG) equations as compared with measured 125I-iothalamate glomerular filtration rate was analyzed in patients with stable renal transplantation (RTx) and in potential living kidney donors (LKD). One hundred and thirty-one patients had RTx and 150 were LKD. The paired t-test showed that the estimated glomerular filtration rate (GFR) values through the aMDRD and the corrected CG equations were significantly different from each other (p < 0.01). There were significant differences between GFRs estimated using aCG and aMDRD equations (p < 0.001) in both groups (RTx and LKD) of different ages. The Pearson correlation coefficient between aCG and aMDRD equations was good (0.77, p < 0.01), but the kappa coefficient was 0.39, indicating a low agreement between the two formulae. In RTx patients with GFR <60 mL/min/1.73 m2, the aMDRD equation performed better than the aCG formula with respect to bias (-0.6 vs. 3.0 mL/min/1.73 m2, respectively) and accuracy within 30% (72% vs. 56%, respectively) and 50% (91% vs. 73%, respectively). Similar results are reported for 48 diabetic RTx patients. In the LKD, the aMDRD equation significantly underestimated the measured GFR when compared with the aCG formula, with a bias of -8.0 versus 2.2 mL/min/1.73 m(2), respectively (p < 0.05). We can conclude that the Cockroft and MDRD equations cannot be used interchangeably in clinical transplantation practice and in order to adjust drug doses.
authors.affiliation: Department of Nephrology, Cairo University, Cairo, Egypt. aroshdy@hotmail.com
authors.forename: Amin R
authors.initials: AR
authors.lastname: Soliman
authors.forename: Ahmed
authors.initials: A
authors.lastname: Fathy
authors.forename: Sahier
authors.initials: S
authors.lastname: Khashab
authors.forename: Noha
authors.initials: N
authors.lastname: Shaheen
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D004032:Diet / Q000145:classification*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000601:surgery; D055815:Young Adult