title: MDRD versus CKD-EPI equation to estimate glomerular filtration rate in kidney transplant recipients.
abstract: BACKGROUND
  The new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-based equation was developed to address the systematic underestimation of the glomerular filtration rate (GFR) by the Modification of Diet in Renal Disease (MDRD) Study equation in patients with a relatively well-preserved kidney function. The performance of the new equation for kidney transplant recipients is discussed.
  
  
  METHODS
  We analyzed the performances of the CKD-EPI equation in comparison with the MDRD Study equation in 825 stable kidney transplant recipients. Bias, precision, and accuracy within 30% of true GFR were determined. GFR was measured by urinary clearance of inulin (n=488) and plasma clearance of Cr-EDTA (n=337).
  
  
  RESULTS
  Mean measured GFR (mGFR) was 50±19 mL/min/1.73 m. On the whole cohort, bias was significantly lower for MDRD Study equation compared with CKD-EPI creatinine. This superiority translates into a better accuracy (80% and 74% for the MDRD and CKD-EPI creatinine, respectively). The best performance of the MDRD Study equation is confirmed both in the subgroups of patients with mGFR <60 mL/min/1.73 m and between 60 and 90 mL/min/1.73 m. For mGFR >90 mL/min/1.73 m, there were no significant differences between the two equations in terms of performance.
  
  
  CONCLUSIONS
  The CKD-EPI creatinine equation does not offer a better GFR prediction in renal transplant patients compared with the MDRD Study equation, even in the earlier CKD stages.
authors.affiliation: Renal Laboratory and Department of Nephrology-Dialysis-Transplantation, University Jean Monnet, CHU Hôpital Nord, Saint-Etienne, France.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Masson
authors.forename: Martin
authors.initials: M
authors.lastname: Flamant
authors.forename: Nicolas
authors.initials: N
authors.lastname: Maillard
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Rule
authors.forename: François
authors.initials: F
authors.lastname: Vrtovsnik
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Peraldi
authors.forename: Lise
authors.initials: L
authors.lastname: Thibaudin
authors.forename: Etienne
authors.initials: E
authors.lastname: Cavalier
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Vidal-Petiot
authors.forename: Christine
authors.initials: C
authors.lastname: Bonneau
authors.forename: Olivier
authors.initials: O
authors.lastname: Moranne
authors.forename: Eric
authors.initials: E
authors.lastname: Alamartine
authors.forename: Christophe
authors.initials: C
authors.lastname: Mariat
authors.forename: Pierre
authors.initials: P
authors.lastname: Delanaye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology
chemical_list: D003404:Creatinine