Document Detail

Pregnancy reduces the accuracy of the estimated glomerular filtration rate based on Cockroft-Gault and MDRD formulas.
MedLine Citation:
PMID:  21079240     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study aims to determine the effect of pregnancy on the accuracy of 3 commonly used methods to estimate glomerular filtration rate ([GFR] creatinine clearance, the Cockroft-Gault, and modification of diet in renal disease [MDRD] formulas) using the inulin clearance as a reference.
DESIGN: Longitudinal study design.
SETTING: University hospital.
POPULATION: A total of 44 parous nonsmoking Caucasian women. They had a history of uneventful pregnancy (n = 9), preeclampsia (n = 27), and intrauterine fetal demise (n = 8).
METHODS: Measurements were performed both in pre-pregnancy and early pregnancy (8 weeks of gestation) and included inulin infusion, blood pressure, and 24-hour urinary and serum creatinine. Agreement between methods to estimate GFR was assessed by the Bland and Altman method.
MAIN OUTCOME MEASURES: GFR estimated by inulin and creatinine clearances and the Cockroft-Gault and MDRD formulas.
RESULTS: During early pregnancy, the GFR measured by inulin increased 32% compared with the pre-pregnant value (from 115 ± 18 to 150 ± 23 mL/min·1.73 m(-2)), whilst the GFR measured by the indirect methods only increased 20%. The observed bias and limits of agreements are larger in early pregnancy relative to the pre-pregnant state for all 3 methods.
CONCLUSION: The renal hyperfiltration during pregnancy decreases further the accuracy of the creatinine clearance and the Cockroft-Gault and MDRD formulas to estimate GFR.
Patricia M J L Koetje; Julia J Spaan; Jeroen P Kooman; Marc E A Spaanderman; Louis L Peeters
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-11-15
Journal Detail:
Title:  Reproductive sciences (Thousand Oaks, Calif.)     Volume:  18     ISSN:  1933-7205     ISO Abbreviation:  Reprod Sci     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-11     Completed Date:  2012-08-07     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  101291249     Medline TA:  Reprod Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  456-62     Citation Subset:  IM    
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MeSH Terms
Blood Pressure / physiology
Creatinine / metabolism
Food Habits / physiology
Glomerular Filtration Rate / physiology*
Inulin / metabolism
Kidney Diseases / diagnosis,  metabolism
Kidney Function Tests / methods,  standards*
Longitudinal Studies
Metabolic Clearance Rate / physiology
Pregnancy / metabolism*
Pregnancy Complications / diagnosis,  metabolism
Statistics as Topic
Reg. No./Substance:
9005-80-5/Inulin; AYI8EX34EU/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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