Characteristics of population with normal serum creatinine impaired renal function and: The validation of a MDRD formula in a healthy general population

Young Sun Kang, K. H. Han, S. Y. Han, H. K. Kim, Dae-Ryong Cha

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background and aims: Glomerular filtration rate (GFR) provides the most accurate estimation of renal function. This study investigated the clinical characteristics of patients with impaired renal function having a normal serum creatinine level. We also validated whether the new Modification of Diet in Renal Disease (MDRD) formula can be applied in a healthy general population. Material and methods: A total 393 participants who had serum creatinine concentration below 132.6 μmol/L without underlying diseases were randomly selected on an address basis in Ansan City. According to the level of GFR, they were divided into 3 groups and we analyzed their clinical characteristics. In 75 subjects, who were randomly selected 25 cases in each group based on GFR estimated by Cockcroft-Gault (C-G) formula, true GFR was measured using the 99mTc-DTPA renal clearance method. Results: A total 393 (male: 106, female: 287) participants were as follows: GFR < 60 ml/min/1.73 m2; 4% (n = 25); 60: ≤ GFR < 90 ml/min/1.73 m2; 26.2% (n = 103); GFR ≥ 90 ml/min/1.73 m2; 67.4% (n = 265). In the group of decreased GFR, the mean age was older (67.4 ± 10.7 vs. 48.7 ± 12.8 vs. 39.4 ± 8.2 years, p < 0.001), the gender was male (90.33 ± 28.77 vs. 110.55 ± 31.64, p < 0.001), and amount of proteinuria more increased (0.61 (0.56) vs. 0.33 (0.34) vs. 0.38 (0.33) gm/day, p = 0.007). The accuracy and precision of each formula were assessed by the difference in GFR measured by the 99mTc-DTPA renal clearance method - estimated GFR by each formula (ΔGFR), and the coefficient of determination (r2) of different predictive equations. The results were as follows: ΔGFR = -14.78 ± 46.03, r2 = 0.79 (24-hour urinary creatinine clearance), ΔGFR = -16.79 ± 57.32, r2 = 0.66 (100/serum creatinine), ΔGFR = 9.54 ± 39.18, r2 = 0.87 (C-G formula), ΔGFR = -12.30 ± 54.31, r2 = 0.66 (AASK formula), ΔGFR = 8.70 ± 37.62, r2 = 0.79 (MDRD formula). Multiple linear regression analysis and logistic regression analysis showed that age, serum creatinine, total cholesterol and 24-hour urinary protein excretion were independently related to GFR and associated with a significant increase in the risk of decrement of GFR. Conclusions: From these results, a more accurate assessment of renal function should be required in a population characterized by older age, male gender and more proteinuria. The MDRD study formula and Cockcroft-Gault formula have greater accuracy and precision with true GFR, and this equation can be applied in subjects with healthy general population.

Original languageEnglish
Pages (from-to)258-266
Number of pages9
JournalClinical Nephrology
Volume63
Issue number4
DOIs
Publication statusPublished - 2005 Jan 1

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Diet Therapy
Population Characteristics
Glomerular Filtration Rate
Creatinine
Kidney
Serum
Population
Pentetic Acid
Proteinuria
Regression Analysis

Keywords

  • Creatinine clearance
  • Glomerular filtration rate (GFR)
  • Kidney function

ASJC Scopus subject areas

  • Nephrology

Cite this

Characteristics of population with normal serum creatinine impaired renal function and : The validation of a MDRD formula in a healthy general population. / Kang, Young Sun; Han, K. H.; Han, S. Y.; Kim, H. K.; Cha, Dae-Ryong.

In: Clinical Nephrology, Vol. 63, No. 4, 01.01.2005, p. 258-266.

Research output: Contribution to journalArticle

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abstract = "Background and aims: Glomerular filtration rate (GFR) provides the most accurate estimation of renal function. This study investigated the clinical characteristics of patients with impaired renal function having a normal serum creatinine level. We also validated whether the new Modification of Diet in Renal Disease (MDRD) formula can be applied in a healthy general population. Material and methods: A total 393 participants who had serum creatinine concentration below 132.6 μmol/L without underlying diseases were randomly selected on an address basis in Ansan City. According to the level of GFR, they were divided into 3 groups and we analyzed their clinical characteristics. In 75 subjects, who were randomly selected 25 cases in each group based on GFR estimated by Cockcroft-Gault (C-G) formula, true GFR was measured using the 99mTc-DTPA renal clearance method. Results: A total 393 (male: 106, female: 287) participants were as follows: GFR < 60 ml/min/1.73 m2; 4{\%} (n = 25); 60: ≤ GFR < 90 ml/min/1.73 m2; 26.2{\%} (n = 103); GFR ≥ 90 ml/min/1.73 m2; 67.4{\%} (n = 265). In the group of decreased GFR, the mean age was older (67.4 ± 10.7 vs. 48.7 ± 12.8 vs. 39.4 ± 8.2 years, p < 0.001), the gender was male (90.33 ± 28.77 vs. 110.55 ± 31.64, p < 0.001), and amount of proteinuria more increased (0.61 (0.56) vs. 0.33 (0.34) vs. 0.38 (0.33) gm/day, p = 0.007). The accuracy and precision of each formula were assessed by the difference in GFR measured by the 99mTc-DTPA renal clearance method - estimated GFR by each formula (ΔGFR), and the coefficient of determination (r2) of different predictive equations. The results were as follows: ΔGFR = -14.78 ± 46.03, r2 = 0.79 (24-hour urinary creatinine clearance), ΔGFR = -16.79 ± 57.32, r2 = 0.66 (100/serum creatinine), ΔGFR = 9.54 ± 39.18, r2 = 0.87 (C-G formula), ΔGFR = -12.30 ± 54.31, r2 = 0.66 (AASK formula), ΔGFR = 8.70 ± 37.62, r2 = 0.79 (MDRD formula). Multiple linear regression analysis and logistic regression analysis showed that age, serum creatinine, total cholesterol and 24-hour urinary protein excretion were independently related to GFR and associated with a significant increase in the risk of decrement of GFR. Conclusions: From these results, a more accurate assessment of renal function should be required in a population characterized by older age, male gender and more proteinuria. The MDRD study formula and Cockcroft-Gault formula have greater accuracy and precision with true GFR, and this equation can be applied in subjects with healthy general population.",
keywords = "Creatinine clearance, Glomerular filtration rate (GFR), Kidney function",
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TY - JOUR

T1 - Characteristics of population with normal serum creatinine impaired renal function and

T2 - The validation of a MDRD formula in a healthy general population

AU - Kang, Young Sun

AU - Han, K. H.

AU - Han, S. Y.

AU - Kim, H. K.

AU - Cha, Dae-Ryong

PY - 2005/1/1

Y1 - 2005/1/1

N2 - Background and aims: Glomerular filtration rate (GFR) provides the most accurate estimation of renal function. This study investigated the clinical characteristics of patients with impaired renal function having a normal serum creatinine level. We also validated whether the new Modification of Diet in Renal Disease (MDRD) formula can be applied in a healthy general population. Material and methods: A total 393 participants who had serum creatinine concentration below 132.6 μmol/L without underlying diseases were randomly selected on an address basis in Ansan City. According to the level of GFR, they were divided into 3 groups and we analyzed their clinical characteristics. In 75 subjects, who were randomly selected 25 cases in each group based on GFR estimated by Cockcroft-Gault (C-G) formula, true GFR was measured using the 99mTc-DTPA renal clearance method. Results: A total 393 (male: 106, female: 287) participants were as follows: GFR < 60 ml/min/1.73 m2; 4% (n = 25); 60: ≤ GFR < 90 ml/min/1.73 m2; 26.2% (n = 103); GFR ≥ 90 ml/min/1.73 m2; 67.4% (n = 265). In the group of decreased GFR, the mean age was older (67.4 ± 10.7 vs. 48.7 ± 12.8 vs. 39.4 ± 8.2 years, p < 0.001), the gender was male (90.33 ± 28.77 vs. 110.55 ± 31.64, p < 0.001), and amount of proteinuria more increased (0.61 (0.56) vs. 0.33 (0.34) vs. 0.38 (0.33) gm/day, p = 0.007). The accuracy and precision of each formula were assessed by the difference in GFR measured by the 99mTc-DTPA renal clearance method - estimated GFR by each formula (ΔGFR), and the coefficient of determination (r2) of different predictive equations. The results were as follows: ΔGFR = -14.78 ± 46.03, r2 = 0.79 (24-hour urinary creatinine clearance), ΔGFR = -16.79 ± 57.32, r2 = 0.66 (100/serum creatinine), ΔGFR = 9.54 ± 39.18, r2 = 0.87 (C-G formula), ΔGFR = -12.30 ± 54.31, r2 = 0.66 (AASK formula), ΔGFR = 8.70 ± 37.62, r2 = 0.79 (MDRD formula). Multiple linear regression analysis and logistic regression analysis showed that age, serum creatinine, total cholesterol and 24-hour urinary protein excretion were independently related to GFR and associated with a significant increase in the risk of decrement of GFR. Conclusions: From these results, a more accurate assessment of renal function should be required in a population characterized by older age, male gender and more proteinuria. The MDRD study formula and Cockcroft-Gault formula have greater accuracy and precision with true GFR, and this equation can be applied in subjects with healthy general population.

AB - Background and aims: Glomerular filtration rate (GFR) provides the most accurate estimation of renal function. This study investigated the clinical characteristics of patients with impaired renal function having a normal serum creatinine level. We also validated whether the new Modification of Diet in Renal Disease (MDRD) formula can be applied in a healthy general population. Material and methods: A total 393 participants who had serum creatinine concentration below 132.6 μmol/L without underlying diseases were randomly selected on an address basis in Ansan City. According to the level of GFR, they were divided into 3 groups and we analyzed their clinical characteristics. In 75 subjects, who were randomly selected 25 cases in each group based on GFR estimated by Cockcroft-Gault (C-G) formula, true GFR was measured using the 99mTc-DTPA renal clearance method. Results: A total 393 (male: 106, female: 287) participants were as follows: GFR < 60 ml/min/1.73 m2; 4% (n = 25); 60: ≤ GFR < 90 ml/min/1.73 m2; 26.2% (n = 103); GFR ≥ 90 ml/min/1.73 m2; 67.4% (n = 265). In the group of decreased GFR, the mean age was older (67.4 ± 10.7 vs. 48.7 ± 12.8 vs. 39.4 ± 8.2 years, p < 0.001), the gender was male (90.33 ± 28.77 vs. 110.55 ± 31.64, p < 0.001), and amount of proteinuria more increased (0.61 (0.56) vs. 0.33 (0.34) vs. 0.38 (0.33) gm/day, p = 0.007). The accuracy and precision of each formula were assessed by the difference in GFR measured by the 99mTc-DTPA renal clearance method - estimated GFR by each formula (ΔGFR), and the coefficient of determination (r2) of different predictive equations. The results were as follows: ΔGFR = -14.78 ± 46.03, r2 = 0.79 (24-hour urinary creatinine clearance), ΔGFR = -16.79 ± 57.32, r2 = 0.66 (100/serum creatinine), ΔGFR = 9.54 ± 39.18, r2 = 0.87 (C-G formula), ΔGFR = -12.30 ± 54.31, r2 = 0.66 (AASK formula), ΔGFR = 8.70 ± 37.62, r2 = 0.79 (MDRD formula). Multiple linear regression analysis and logistic regression analysis showed that age, serum creatinine, total cholesterol and 24-hour urinary protein excretion were independently related to GFR and associated with a significant increase in the risk of decrement of GFR. Conclusions: From these results, a more accurate assessment of renal function should be required in a population characterized by older age, male gender and more proteinuria. The MDRD study formula and Cockcroft-Gault formula have greater accuracy and precision with true GFR, and this equation can be applied in subjects with healthy general population.

KW - Creatinine clearance

KW - Glomerular filtration rate (GFR)

KW - Kidney function

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