Prediction of decline in GFR from estimated creatinine clearance in chronic renal failure
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:74A 1997
In this study several formulas and nomograms for predicting creatinine clearance from serum creatinine values are compared in 32 chronic renal failure patients using constant infusion of 51Cr-EDTA clearance as reference. The estimation formulas are used in this study to predict changes of GFR every third month during 28.2 months of follow-up in every single patient. The analysis was based on the limits of agreement method (mean of the differences ± two standard deviations) plus the analysis of the relationships between the differences between two methods and the mean value of the same two methods to detect systematic errors. Only 3 methods showed no systematic error in evaluating the rate of decline in GFR: Edwards 1959, Mawer 1972, Jelliffe 1973. Measured creatinine clearance also showed favourable results.
Comment: Prediction of the glomerular filtration rate from estimated creatinine clearance is still a debated issue because the universally used Cockcroft and Gault formula presents some limitations. Differences between predicted and measured creatinine clearance are present when creatinine production is lower than normal due to malnutrition, neuromuscular diseases, kidney, chronic liver and heart diseases. Differences between creatinine clearance and true GFR are also present in advanced chronic renal failure because of creatinine tubular secretion. In this study other interesting formulas for creatinine clearance prediction are considered. (Gianpaolo Amici, M.D., Treviso, Italy).
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ASN 30th Annual Meeting, San Antonio
Assessing renal function : Creatinine clearance