Assessing glomerular filtration rate (GFR) in elderly Chinese patients with chronic kidney disease (CKD): A comparison of various predictive equations

The aim of this study was to evaluate the applicability of formulas based on serum creatinine (SC) levels in elderly Chinese patients with CKD. A total of 103 elderly CKD patients were investigated. The GFR was estimated with Cockcroft-Gault-equation, MDRD1-equation, abbreviated MDRD-equation, Jelliffe-1973-equation, Mawer-equation, Hull-equation, Jelliffe-1971-equation, SC-reciprocal-equation, Gate-equation and Bjornsson-equation. The accuracy of estimated GFR (eGFR) values was compared with the 99mTc-DTPA-GFR (standardized GFR = sGFR) in elderly CKD patients. Bland-Altman analysis demonstrated that Hull-equation, Cockcroft-Gault-equation and Bjornsson-equation were better than the other ones. However, the agreement limits of all the equations exceeded the prior acceptable tolerances defined as 60 ml/min/(1.73 m(2)). Linear regressions showed that the slopes of Jelliffe-1973-equation, Cockcroft-Gault-equation and Bjornsson-equation were closer to the identical line. The median of difference of MDRD1-equation, abbreviated MDRD-equation and Gate-equation were smaller. Accuracy of Jelliffe-1973-equation, Cockcroft-Gault-equation and Hull-equation were better than those of the other equations. But 30% accuracy of all the equations were less than 70%. When compared the bias as well as accuracy of eGFR with sGFR values in different stages of CKD, GFR estimated by MDRD1-equation, Hull-equation, Cockcroft-Gault-equation and Jelliffe-1973-equation showed good results. These results suggested that when SC was checked with enzymatic method, GFR-estimation equations may show great bias in elderly Chinese CKD patients. Further improved formulas are needed to evaluate renal function in elderly Chinese patients with CKD. Crown Copyright (C) 2009 Published by Elsevier Ireland Ltd. All rights reserved.