Document Detail


Predictive performance of eGFR equations in South Africans of African and Indian ancestry compared with (99m)Tc-DTPA imaging.
MedLine Citation:
PMID:  21373844     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: South African guidelines for early detection and management of chronic kidney disease (CKD) recommend using the Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) equations for calculating estimated glomerular filtration rate (eGFR) with the correction factor, 1.212, included for MDRD-eGFR in black patients. We compared eGFR against technetium-99m-diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) imaging. METHODS: Using clinical records, we retrospectively recorded demographic, clinical, and laboratory data as well as (99m)Tc-DTPA-measured GFR (mGFR) results obtained from routine visits. Data from 148 patients of African (n = 91) and Indian (n = 57) ancestry were analyzed. RESULTS: Median (IQR) mGFR was 38.5 (44) ml/min/1.73 m(2), with no statistical difference between African and Indian patients (P = 0. 573). In African patients with stage 3 CKD, MDRD-eGFR (unadjusted for black ethnicity) overestimated mGFR by 5.3% [2.0 (16.0) ml/min/1.73 m(2)] compared to CG-eGFR and MDRD-eGFR (corrected for black ethnicity) that overestimated mGFR by 17.7% [6.0 (15.0) ml/min/1.73 m(2)] and 17.1% [6.0 (17.5) ml/min/1.73 m(2)], respectively. In stage 1-2, CKD eGFR overestimated mGFR by 52.5, 38.0, and 19.3% for CG, MDRD (ethnicity-corrected), and MDRD (without correction), respectively. In Indian stage 3 CKD patients, MDRD-eGFR underestimated mGFR by 35.6% [-21.0 (6.5) ml/min/1.73 m(2)] and CG-eGFR by 4.4% [-2.0 (27.0) ml/min/1.73 m(2)], while in stage 1-2 CKD, CG-eGFR and MDRD-eGFR overestimated mGFR by 13.8 and 6.3%, respectively. CONCLUSION: MDRD-eGFR calculated without the African-American correction factor improved GFR prediction in African CKD patients and using the MDRD correction factor of 1.0 in Indian patients as in Caucasians may be inappropriate.
Authors:
Nomandla D Madala; Ntombifikile Nkwanyana; Thozama Dubula; Indiran P Naiker
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-5
Journal Detail:
Title:  International urology and nephrology     Volume:  -     ISSN:  1573-2584     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
King Edward Hospital Renal Clinic, Department of Nephrology, Division of Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa, madalan@nu.ac.za.
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