title: Modification of Diet in Renal Disease versus Chronic Kidney Disease Epidemiology Collaboration equation to estimate glomerular filtration rate in obese patients.
abstract: BACKGROUND
  Obesity is a recognized risk factor for both the development and progression of chronic kidney disease (CKD). Accurate estimation of glomerular filtration rate (GFR) is thus important in these patients. We tested the performances of two creatinine-based GFR estimates, the Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, in an obese population.
  
  
  METHODS
  Patients with body mass index (BMI) > 30 kg/m(2) were included. The reference method for measured GFR (mGFR) was (51)Cr-EDTA (single-injection method, two blood samples at 120 and 240 min). Both indexed and non-indexed results were considered. Serum creatinine was measured using the IDMS-traceable compensated Jaffe method. Mean bias (eGFR-mGFR), precision (SD around the bias) and accuracy within 30% (percentage of estimations within 30% of mGFR) were calculated for both equations.
  
  
  RESULTS
  The population included 366 patients (185 women) from two different areas. Mean age was 55 ± 14 years, and mean BMI was 36 ± 7 kg/m(2). Mean mGFR was 56 ± 26 mL/min/1.73 m(2) (71 ± 35 mL/min without indexation). In the total population, mean bias was +1.9 ± 14.3 and +4.6 ± 14.7 mL/min/1.73 m(2) (P < 0.05), and accuracy 30% was 80 and 76% for the MDRD and CKD-EPI equations (P < 0.05), respectively. In patients with mGFR > 60 mL/min/1.73 m(2), mean bias was +4.6 ± 18.4 and +9.3 ± 17.2 mL/min/1.73 m(2) (P < 0.05), and accuracy 30% was 81 and 79% (NS) for the MDRD and CKD-EPI equations, respectively.
  
  
  CONCLUSIONS
  The CKD-EPI equation did not outperform the MDRD study equation in this population of obese patients.
authors.affiliation: Department of Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium.
authors.forename: Antoine
authors.initials: A
authors.lastname: Bouquegneau
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Vidal-Petiot
authors.forename: François
authors.initials: F
authors.lastname: Vrtovsnik
authors.forename: Etienne
authors.initials: E
authors.lastname: Cavalier
authors.forename: Marcelle
authors.initials: M
authors.lastname: Rorive
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Krzesinski
authors.forename: Pierre
authors.initials: P
authors.lastname: Delanaye
authors.forename: Martin
authors.initials: M
authors.lastname: Flamant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D004032:Diet; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000178:diet therapy; D051437:Renal Insufficiency / Q000178:diet therapy / Q000453:epidemiology / Q000503:physiopathology*; D051436:Renal Insufficiency, Chronic / Q000178:diet therapy / Q000453:epidemiology / Q000503:physiopathology*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D003404:Creatinine
keywords: CKD-EPI; MDRD; creatinine; glomerular filtration rate; obesity