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Ethnic coefficients for glomerular filtration rate estimation by the Modification of Diet in Renal Disease study equations in the Korean population.

Lee CS, Cha RH, Lim YH, Kim H, Song KH, Gu N, Yu KS, Lim CS, Han JS, Kim S, Kim YS - J. Korean Med. Sci. (2010)

Bottom Line: Reference GFR was measured by systemic inulin clearance.Coefficients for the 4 and 6 variable MDRD equations based on the SCr measured by Jaffé method were 1.09825 and 1.04334, respectively.The modified equations showed better performances than the original equations.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT
Race and ethnicity are influential in estimating glomerular filtration rate (GFR). We aimed to find the Korean coefficients for the Modification of Diet in Renal Disease (MDRD) study equations and to obtain novel proper estimation equations. Reference GFR was measured by systemic inulin clearance. Serum creatinine (SCr) values were measured by the alkaline picrate Jaffé kinetic method, then, recalibrated to CX3 analyzer and to isotope dilution mass spectrometry (IDMS). The Korean coefficients for the 4 and 6 variable MDRD and IDMS MDRD study equations based on the SCr recalibrated to CX3 and to IDMS were 0.73989/0.74254 and 0.99096/0.9554, respectively. Coefficients for the 4 and 6 variable MDRD equations based on the SCr measured by Jaffé method were 1.09825 and 1.04334, respectively. The modified equations showed better performances than the original equations. The novel 4 variable equations for Korean based on the SCr measured and recalibrated to IDMS were 107.904×SCr(-1.009)×age(-0.02) (×0.667, if woman) and 87.832×SCr(-0.882)×age(0.01) (×0.653, if woman), respectively. Modified estimations of the MDRD and IDMS MDRD study equations with ethnic coefficients and the novel equations improve the performance of GFR estimation for the overall renal function.

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Correlation of estimated glomerular filatration rate (eGFR) (equations 1-8) with systemic inulin clearance (reference GFR) (A) and Bland and Altman plots between eGFR (equations 1-8) and systemic inulin clearance (B) (n=147; excluding participants whose reference GFR exceeded 130 mL/min/1.73 m2). (A) Black line: Identical line, gray line: Fit line between systemic inulin clearance and eGFR. Modification of the Modification of Diet in Renal Disease (MDRD) study equations using serum creatinine (SCr) values recalibrated to CX3 analyzer (Cleveland Clinic Reference Laboratory) underestimated GFR for all stages of renal function. (B) Solid red line represents the regression line of difference between methods against average of methods. The mean difference is indicated by center line, limits of agreement are indicated by the upper (mean+2SD) and lower (mean-2SD) lines. Eq1-Eq4: Equations 1-4: The MDRD and Isotope Dilution Mass Spectrometry (IDMS) MDRD study equations using SCr values recalibrated to CX3 analyzer and to IDMS. Eq5-Eq8: Equations 1-4 multiplied by the Korean ethnic coefficients.
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Figure 1: Correlation of estimated glomerular filatration rate (eGFR) (equations 1-8) with systemic inulin clearance (reference GFR) (A) and Bland and Altman plots between eGFR (equations 1-8) and systemic inulin clearance (B) (n=147; excluding participants whose reference GFR exceeded 130 mL/min/1.73 m2). (A) Black line: Identical line, gray line: Fit line between systemic inulin clearance and eGFR. Modification of the Modification of Diet in Renal Disease (MDRD) study equations using serum creatinine (SCr) values recalibrated to CX3 analyzer (Cleveland Clinic Reference Laboratory) underestimated GFR for all stages of renal function. (B) Solid red line represents the regression line of difference between methods against average of methods. The mean difference is indicated by center line, limits of agreement are indicated by the upper (mean+2SD) and lower (mean-2SD) lines. Eq1-Eq4: Equations 1-4: The MDRD and Isotope Dilution Mass Spectrometry (IDMS) MDRD study equations using SCr values recalibrated to CX3 analyzer and to IDMS. Eq5-Eq8: Equations 1-4 multiplied by the Korean ethnic coefficients.

Mentions: The biases of the modified MDRD study equations (equations 5 and 6) were much less than those of the original MDRD study equations (equations 1 and 2). The biases of the IDMS MDRD study equations were not changed after the modification, with exception of the 6 variable IDMS MDRD study equation. Fifteen to thirty percent accuracy of most modified MDRD and IDMS MDRD study equations were higher than those of the original equations, although statistical significances were not valid (Table 3, Fig. 1).


Ethnic coefficients for glomerular filtration rate estimation by the Modification of Diet in Renal Disease study equations in the Korean population.

Lee CS, Cha RH, Lim YH, Kim H, Song KH, Gu N, Yu KS, Lim CS, Han JS, Kim S, Kim YS - J. Korean Med. Sci. (2010)

Correlation of estimated glomerular filatration rate (eGFR) (equations 1-8) with systemic inulin clearance (reference GFR) (A) and Bland and Altman plots between eGFR (equations 1-8) and systemic inulin clearance (B) (n=147; excluding participants whose reference GFR exceeded 130 mL/min/1.73 m2). (A) Black line: Identical line, gray line: Fit line between systemic inulin clearance and eGFR. Modification of the Modification of Diet in Renal Disease (MDRD) study equations using serum creatinine (SCr) values recalibrated to CX3 analyzer (Cleveland Clinic Reference Laboratory) underestimated GFR for all stages of renal function. (B) Solid red line represents the regression line of difference between methods against average of methods. The mean difference is indicated by center line, limits of agreement are indicated by the upper (mean+2SD) and lower (mean-2SD) lines. Eq1-Eq4: Equations 1-4: The MDRD and Isotope Dilution Mass Spectrometry (IDMS) MDRD study equations using SCr values recalibrated to CX3 analyzer and to IDMS. Eq5-Eq8: Equations 1-4 multiplied by the Korean ethnic coefficients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2966999&req=5

Figure 1: Correlation of estimated glomerular filatration rate (eGFR) (equations 1-8) with systemic inulin clearance (reference GFR) (A) and Bland and Altman plots between eGFR (equations 1-8) and systemic inulin clearance (B) (n=147; excluding participants whose reference GFR exceeded 130 mL/min/1.73 m2). (A) Black line: Identical line, gray line: Fit line between systemic inulin clearance and eGFR. Modification of the Modification of Diet in Renal Disease (MDRD) study equations using serum creatinine (SCr) values recalibrated to CX3 analyzer (Cleveland Clinic Reference Laboratory) underestimated GFR for all stages of renal function. (B) Solid red line represents the regression line of difference between methods against average of methods. The mean difference is indicated by center line, limits of agreement are indicated by the upper (mean+2SD) and lower (mean-2SD) lines. Eq1-Eq4: Equations 1-4: The MDRD and Isotope Dilution Mass Spectrometry (IDMS) MDRD study equations using SCr values recalibrated to CX3 analyzer and to IDMS. Eq5-Eq8: Equations 1-4 multiplied by the Korean ethnic coefficients.
Mentions: The biases of the modified MDRD study equations (equations 5 and 6) were much less than those of the original MDRD study equations (equations 1 and 2). The biases of the IDMS MDRD study equations were not changed after the modification, with exception of the 6 variable IDMS MDRD study equation. Fifteen to thirty percent accuracy of most modified MDRD and IDMS MDRD study equations were higher than those of the original equations, although statistical significances were not valid (Table 3, Fig. 1).

Bottom Line: Reference GFR was measured by systemic inulin clearance.Coefficients for the 4 and 6 variable MDRD equations based on the SCr measured by Jaffé method were 1.09825 and 1.04334, respectively.The modified equations showed better performances than the original equations.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT
Race and ethnicity are influential in estimating glomerular filtration rate (GFR). We aimed to find the Korean coefficients for the Modification of Diet in Renal Disease (MDRD) study equations and to obtain novel proper estimation equations. Reference GFR was measured by systemic inulin clearance. Serum creatinine (SCr) values were measured by the alkaline picrate Jaffé kinetic method, then, recalibrated to CX3 analyzer and to isotope dilution mass spectrometry (IDMS). The Korean coefficients for the 4 and 6 variable MDRD and IDMS MDRD study equations based on the SCr recalibrated to CX3 and to IDMS were 0.73989/0.74254 and 0.99096/0.9554, respectively. Coefficients for the 4 and 6 variable MDRD equations based on the SCr measured by Jaffé method were 1.09825 and 1.04334, respectively. The modified equations showed better performances than the original equations. The novel 4 variable equations for Korean based on the SCr measured and recalibrated to IDMS were 107.904×SCr(-1.009)×age(-0.02) (×0.667, if woman) and 87.832×SCr(-0.882)×age(0.01) (×0.653, if woman), respectively. Modified estimations of the MDRD and IDMS MDRD study equations with ethnic coefficients and the novel equations improve the performance of GFR estimation for the overall renal function.

Show MeSH
Related in: MedlinePlus