The development and comparison of estimated glomerular filtration rate equations

doi:10.3969/j.issn.1673-8640.2015.07.002

Abstract

Abstract:

The key to diagnose kidney diseases early relies on accurate judgement on glomerular filtration rate (GFR). Some estimated glomerular filtration rate (eGFR) equations have been developed in order to facilitate clinical use of GFR based on such filtration markers as creatinine (Cr) and cystatin C (Cys C). The earliest equation is Cockcroft-Gault (C-G) equation which relies on chronic kidney disease (CKD) patients with a small quantity, and it could be influenced with so many factors. Nowadays, C-G equation is thought to be more fit for estimating endogenous creatinine clearance rate. Modification of diet in renal disease (MDRD) equation developed later also relies on CKD patients with more subjects involved. However, it is not accurate being used in healthy subjects and non-kidney disease patients, which partially was led by the standardization problem of filtration marker determination. After Cr and Cys C assay standardizations are completed, the MDRD equation performance in clinical use is still not quite ideal, because the equation is established upon CKD patients that it performs well in this limited subjects. The chronic kidney disease epidemiology collaboration (CKD-EPI) equation is developed on CKD patients and more healthy subjects as well, thus its clinical use is much better. CKD-EPI equation based on Cr is more accurate than those based on Cr and Cys C. The eGFR equations have simplifed the evaluating process of kidney function, however, they are fitted through mathematic models, so the chosen method of measured GFR(mGFR) directly decides whether the developed eGFR equation would be accurate or not. Filtration marker determination could be influenced by so many factors, therefore the consistence of advancing the standardization of filtration markers is also a guarantee to the accuracy of the equations. Considering of the factors such as race, diet and muscle mass, the accuracy of eGFR equations depends on using in similar patients as the equation developing subjects.

Key words: Glomerular filtration rate, Equation, Kidney function

CLC Number:

R446.1

WANG Yin, WANG Beili, GUO Wei, PAN Baishen. The development and comparison of estimated glomerular filtration rate equations[J]. Laboratory Medicine, 2015, 30(7): 668-673.

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