Comparison of commonly used creatinine-based GFR estimating formulas in elderly female non-diabetic patients with chronic kidney disease
More details
Hide details
Collegium Medicum, Jan Kochanowski University in Kielce, Poland
Faculty of Medical Science, Higher School of Economy, Law and Medical Science of professor Edward Lipiński in Kielce, Poland
Out-Patient Clinic Esculap Gniewkowo, Gniewkowo, Poland
Department of Nephrology, Institute of Medical Science, Jan Kochanowski University in Kielce, Poland
Arkadiusz Bociek   

Collegium Medicum, Jan Kochanowski University in Kielce, Poland, al. IX Wieków Kielc 19A, 25-317 Kielce +48 503 440 665.
Submission date: 2019-06-13
Final revision date: 2020-01-04
Acceptance date: 2020-01-05
Online publication date: 2020-03-21
Measuring glomerular filtration rate (GFR) with the isotopic method is a gold standard. However, it is an elaborate and expensive procedure, so in everyday practice GFR is estimated with creatinine-based formulas. Despite the number of studies, it remains unclear which GFR estimating equation is the most accurate, especially in increasing elderly population.

The aim of this study was to compare the commonly used formulas to assess which one of them should be used in elderly female non-diabetic patients suffering from chronic kidney disease (CKD)

Material and methods:
336 non-diabetic females aged 70 and more were qualified to the study. On the basis of serum creatinine concentration, estimated GFR (eGFR) was estimated using various formulas.

Results and discussion:
The eGFR and CKD stages differ significantly depending on the used formula. The modification of diet in renal disease equation (MDRD) formula showed slightly, but still significantly, better correlation with creatinine concentration in serum than the CKD epidemiology collaboration equation. The Cockcroft-Gault equation formula was significantly inferior to above mentioned equations. The receiver operating characteristic curves showed that MDRD is the most sensitive equation and the differences between formulas compared in pairs were significant.

Due to its highest correlation with creatinine and its highest sensitivity and specificity, the MDRD formula seems to be the most accurate equation to estimate GFR in elderly non-diabetic females.

None declared.
None declared.
Vassalotti JA, Stevens LA, Levey AS. Testing for Chronic Kidney Disease: A Position Statement From the National Kidney Foundation. Am J Kidney Dis. 2007;50(2):169–180.
Levey AS, Inker LA, Coresh J. GFR estimation: from physiology to public health. Am J Kidney Dis. 2014;63(5):820–834.
Li JT, Xun C, Cui CL, et al. Relative performance of two equations for estimation of glomerular filtration rate in a Chinese population having chronic kidney disease. Chin Med J (Engl). 2012;125(4):599–603.
Sielski J, Janion-Sadowska A. Correlation analysis of BNP concentration and renal function parameters in patients after permanent pacemaker implantation. Med Stud. 2013;29(1):31–37.
Madero M, Sarnak MJ. Creatinine-based formulae for estimating glomerular filtration rate: Is it time to change to chronic kidney disease epidemiology collaboration equation? Curr Opin Nephrol Hypertens. 2011;20(6):622–630.
Schwandt A, Denkinger M, Fasching P, et al. Comparison of MDRD, CKD-EPI, and Cockcroft-Gault equation in relation to measured glomerular filtration rate among a large cohort with diabetes. J Diabetes Complications. 2017;31(9):1376–1383.
Jalalonmuhali M, Lim SK, Md Shah MN, Ng KP. MDRD vs. CKD-EPI in comparison to 51Chromium EDTA: a cross sectional study of Malaysian CKD cohort. BMC Nephrol. 2017;18(1):363.
Hu C, Li D, Yin W, Zuo X. Evaluation of cystatin C-derived glomerular filtration rate equations in Chinese population. Scand J Clin Lab Invest. 2019;79(8):1–6.
Jaroszynski A, Dereziński T, Jaroszyńska A, et al. Association of anthropometric measures of obesity and chronic kidney disease in elderly women. Ann Agric Environ Med. 2016;23(4):636-640.
Stevens PE, Levin A. Evaluation and management of chronic kidney disease: Synopsis of the kidney disease: Improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013;158(11):825–830.
Renke M, Parszuto J, Rybacki M, et al. Chronic kidney disease – The relevant information for an occupational physician. Med Pr. 2017;69(1):67–75. [in Polish].
Chen A, Sun Y, Li W, et al. Application of GFR estimation equations in elderly patients with measured GFR below 60 mL/min/1.73 m2. Aging Clin Exp Res. 2020;32(3):415–422.
White SL, Polkinghorne KR, Atkins RC, Chadban SJ. Comparison of the prevalence and mortality risk of CKD in Australia using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study GFR estimating equations: The AusDiab (Australian Diabetes, Obesity and Lifestyle) Study. Am J Kidney Dis. 2010;55(4):660–670.
Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–612.
Matsushita K, Selvin E, Bash LD, Astor BC, Coresh J. Risk implications of the new CKD Epidemiology Collaboration (CKD-EPI) equation compared with the MDRD Study equation for estimated GFR: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis. 2010;55(4):648–659.
Szeliga-Król J, Zubilewicz R, Panasiuk-Kamińska K, Załuska W, Urbańczuk M, Jaroszyński A. Comparison of the Cockroft–Gault, simplified Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration formulas in the determination of chronic kidney disease advancement. Fam Med Prim Care Rev. 2016;3(3):348–351.
Szarnecka-Sojda A, Miszczuk J, Polewczyk A. Early and long-term complications in haemodialysis vascular access. Med Stud. 2019;34(4):342–348.
Li DY, Yin WJ, Yi YH, et al. Development and validation of a more accurate estimating equation for glomerular filtration rate in a Chinese population. Kidney Int. 2019;95(3):636–646.
Xie P, Huang J-M, Lin H, Wu W-J, Pan L-P. CDK-EPI equation may be the most proper formula based on creatinine in determining glomerular filtration rate in Chinese patients with chronic kidney disease. Int Urol Nephrol. 2013;45(4):1057–1064.
Kilbride HS, Stevens PE, Eaglestone G, et al. Accuracy of the MDRD (Modification of Diet in Renal Disease) study and CKD-EPI (CKD Epidemiology Collaboration) equations for estimation of GFR in the elderly. Am J Kidney Dis. 2013;61(1):57–66.
Botev R, Mallié J-P, Couchoud C, et al. Estimating glomerular filtration rate: Cockcroft-Gault and Modification of Diet in Renal Disease formulas compared to renal inulin clearance. Clin J Am Soc Nephrol. 2009;4(5):899–906.
Maioli C, Cozzolino M, Gallieni M, et al. Evaluation of renal function in elderly patients: Performance of creatinine-based formulae versus the isotopic method using 99mTc- diethylene triamine pentaacetic acid. Nucl Med Commun. 2014;35(4):416–422.
Raman M, Middleton RJ, Kalra PA, Green D. Estimating renal function in old people: an in-depth review. Int Urol Nephrol. 2017;49(11):1979–1988.