Performance of the revised '175' Modification of Diet in Renal Disease equation in patients with type 2 diabetes

Aims/hypothesis Estimation of GFR (eGFR) is recommended for the assessment of kidney function in all patients with diabetes. We studied performance of the traditional '186' Modification of Diet in Renal Disease (MDRD) equation, and the 2005 revised '175' MDRD equation in patients...

Full description

Saved in:
Bibliographic Details
Published in:Diabetologia 2008-09, Vol.51 (9), p.1714-1718
Main Authors: Chudleigh, R. A, Ollerton, R. L, Dunseath, G, Peter, R, Harvey, J. N, Luzio, S, Owens, D. R
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Body Mass Index
Creatinine
Creatinine - blood
Diabetes
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - diet therapy
Diabetes Mellitus, Type 2 - physiopathology
Diabetes. Impaired glucose tolerance
Diabetic Nephropathies - diet therapy
Diabetic Nephropathies - physiopathology
Diet, Diabetic
eGFR
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Feeding Behavior
Female
Glomerular Filtration Rate
Human Physiology
Humans
Internal Medicine
Kidney diseases
Kidney Function Tests
Male
Mass spectrometry
MDRD equation
Medical sciences
Medicine
Medicine & Public Health
Metabolic Diseases
Methods
Middle Aged
noninsulin-dependent diabetes mellitus
Scientific imaging
Short Communication
Standardised creatinine
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aims/hypothesis Estimation of GFR (eGFR) is recommended for the assessment of kidney function in all patients with diabetes. We studied performance of the traditional '186' Modification of Diet in Renal Disease (MDRD) equation, and the 2005 revised '175' MDRD equation in patients with type 2 diabetes. Methods Two hundred and ninety-three mainly normoalbuminuric (267/293) patients were recruited. Patients were classified as having mild renal impairment (group 1, GFR =90 ml min⁻¹ 1.73 m⁻²). eGFR was calculated by the traditional 186 MDRD equation using traditional creatinine values and the revised 175 MDRD equation using isotope dilution mass spectrometry-standardised creatinine values. Isotopic GFR was measured by the four-sample plasma clearance of ⁵¹Cr-EDTA. Results For patients in group 1, mean ± SD isotopic ⁵¹Cr-EDTA GFR (iGFR) was 83.8 ± 4.3 ml min⁻¹ 1.73 m⁻², and eGFR was 73.2 ± 11.9 and 75.8 ± 13.7 ml min⁻¹ 1.73 m⁻² using the 186 and 175 MDRD equations, respectively. Method bias was -10.6 with the 186 MDRD and -7.9 ml min⁻¹ 1.73 m⁻² (p < 0.05) with the 175 MDRD equation. In group 2, iGFR was 119.4 ± 20.2 ml min⁻¹ 1.73 m⁻², and eGFR was 92.3 ± 18.6 and 97.5 ± 21.6 ml min⁻¹ 1.73 m⁻² using the 186 and 175 MDRD equations, respectively. Method bias was -27.1 with the 186 MDRD equation and -21.9 ml min⁻¹ 1.73 m⁻² (p < 0.05) with the 175 MDRD equation. Conclusions/interpretation In patients newly diagnosed with type 2 diabetes, the revised 175 MDRD equation was less biased than the traditional 186 MDRD equation. Despite a continued tendency to underestimate isotopically measured GFR, use of standardised creatinine values is a positive step towards improved estimation of GFR.
ISSN:0012-186X
1432-0428
DOI:10.1007/s00125-008-1086-9