In their 10-minute consultation on
Chronic kidney disease (CKD), Drs. Mitra, et al outline the utility of
eGFR. They assert that eGFR, a number that is based on the "modification
of diet in renal disease" [MDRD] formula, determines the stage of CKD.
However, the MDRD formula relies solely on serum creatinine taking into
account age, gender and ethnicity.
Since serum creatinine excretion declines in the elderly and is determined
by a person’s size and muscle mass, eGFR based on MDRD formula cannot be
reliable for the elderly or at the early stages of CKD.This tool is good
when the GFR is > 60, but less precise for GFR < 60.
There are recent calls to incorporate cystatin C as a measure for renal
function.Despite these limitations, eGFR is considered more reliable than
Cockcroft-Gault equation.
Reference:
Poggio ED, et al
Performance of the modification of diet in renal disease and
Cockcroft-Gault equations in the estimation of GFR in health and chronic
kidney disease.
Am J Soc nephrol 2005; 16:459-66
Rapid Response:
eGFR: MDRD Formula has its limitations
In their 10-minute consultation on
Chronic kidney disease (CKD), Drs. Mitra, et al outline the utility of
eGFR. They assert that eGFR, a number that is based on the "modification
of diet in renal disease" [MDRD] formula, determines the stage of CKD.
However, the MDRD formula relies solely on serum creatinine taking into
account age, gender and ethnicity.
Since serum creatinine excretion declines in the elderly and is determined
by a person’s size and muscle mass, eGFR based on MDRD formula cannot be
reliable for the elderly or at the early stages of CKD.This tool is good
when the GFR is > 60, but less precise for GFR < 60.
There are recent calls to incorporate cystatin C as a measure for renal
function.Despite these limitations, eGFR is considered more reliable than
Cockcroft-Gault equation.
Reference:
Poggio ED, et al
Performance of the modification of diet in renal disease and
Cockcroft-Gault equations in the estimation of GFR in health and chronic
kidney disease.
Am J Soc nephrol 2005; 16:459-66
Competing interests:
None declared
Competing interests: No competing interests