Comparison of CCR, Cockcroft-Gault and Mdrd Formula for the Estimation of Glomerular Filtration Rate

Authors

  • Mimi Parvin Combined Military Hospital, Shaheed Salahuddin Cantonment , Ghatail, Tangail
  • Md Aminul Haque Khan Professor, Department of Biochemistry, Enam Medical College, Savar, Dhaka
  • Muhammad Saiedullah Assistant Professor, Department of Applied Laboratory Sciences, Bangladesh University of Health Sciences (BUHS), Dhaka
  • Muhammad Rezwanur Rahman Associate Professor, Department of Biochemistry, Delta Medical College, Dhaka
  • Md Saiful Islam Commandant, Armed Forces Institute of Pathology (AFIP), Dhaka
  • Lubna Naznin Department of Chemical Pathology, Armed Forces Institute of Pathology (AFIP), Dhaka

DOI:

https://doi.org/10.3329/jbcps.v33i4.28141

Keywords:

CCR, MDRD, Cockcroft-Gault formula, Estimated GFR, eGFR in Bangladeshi population

Abstract

Many organizations recommend the use of equations that provide a rapid method of assessing glomerular filtration rate (GFR) to facilitate the detection, evaluation, and management of chronic kidney diseases. Indeed, many clinical laboratories already report estimated GFR (eGFR) values whenever the serum creatinine level is measured. To compare the predictive equations for the measurement of GFR in Bangladeshi population, we measured GFR by creatinine clearance rate (CCR) and also estimated it by Modification of Diet in Renal Disease (MDRD) 4 variables equation and Cockcroft and Gault (C-G) formula in 61 Bangladeshi subjects who were referred to Armed Forces Institute of Pathology, Dhaka Cantonment for the estimation of GFR by physicians during the period of March 2011 to November 2011. Results are expressed as mean ± SD and compared by two-tailed paired t test, Bland-Altman plots for bias, precision (r2), receiver-operating characteristics (ROC) curve, and accuracy within 15%, 30% and 50% of the measured GFR. We included 39 (63.93%) males and 22 (36.06%) females with mean age of 52±14 years. The GFR measured by CCR was 61.30±37.38 mL/min/1.73 m2 and eGFR by MDRD4 and C-G were 51.26±26.86 (P<0.05), 54.98±27.21 (P>0.05) mL/min/1.73 m2 respectively. The bias was 10.55±25.34 mL/min/1.73 m2 for MDRD, 6.32±25.90 mL/min/1.73 m2 for C-G; precision was 0.5407 for MDRD, 0.5201 for C-G; the areas under the ROC curve was 0.5722 (P>0.05) for MDRD4, 0.5444 (P>0.05) for C-G. The percentages of eGFR falling within 15% and 30% of measured GFR were 30%, 52% for MDRD and 35%, 52% for C-G. Both MDRD4 and C-G showed positive bias at GFR<60 mL/min/1.73 m2 and negative bias at GFR >60 mL/min/1.73 m2. The results indicate that Cockcroft-Gault formula is more accurate than MDRD4 equation in the overall GFR range, but MDRD4 appears to be more accurate at GFR <60 mL/min/1.73 m2.

J Bangladesh Coll Phys Surg 2015; 33(4): 207-212

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Author Biography

Mimi Parvin, Combined Military Hospital, Shaheed Salahuddin Cantonment , Ghatail, Tangail



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Published

2016-06-08

How to Cite

Parvin, M., Khan, M. A. H., Saiedullah, M., Rahman, M. R., Islam, M. S., & Naznin, L. (2016). Comparison of CCR, Cockcroft-Gault and Mdrd Formula for the Estimation of Glomerular Filtration Rate. Journal of Bangladesh College of Physicians and Surgeons, 33(4), 207–212. https://doi.org/10.3329/jbcps.v33i4.28141

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Original Articles