A comparison of different methods for the determination of glomerular filtration rate in elderly patients with chronic renal failure

Objective The aim of the present study was to asses the accuracy of prediction equations in elderly patients with advanced renal disease (ARD). Patients and methods Twenty-three elderly patients (>60 years) with chronic kidney disease (CKD) stages 3–5 underwent technetium-99 m-diethylenetriaminep...

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Bibliographic Details
Published in:International urology and nephrology 2011-03, Vol.43 (1), p.257-263
Main Authors: Macunluoğlu, Beyza, Gökçe, İbrahim, Atakan, Aydın, Demirci, Münir, Arı, Elif, Topuzoğlu, Ahmet, Borazan, Ali
Format: Article
Language:English
Subjects:
Age Factors
Aged
Creatinine - metabolism
Disease Progression
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic - diagnostic imaging
Kidney Failure, Chronic - metabolism
Kidney Failure, Chronic - physiopathology
Kidney Function Tests - methods
Male
Medicine
Medicine & Public Health
Nephrology
Nephrology – Original Paper
Radionuclide Imaging
Reproducibility of Results
Severity of Illness Index
Urology
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Summary:Objective The aim of the present study was to asses the accuracy of prediction equations in elderly patients with advanced renal disease (ARD). Patients and methods Twenty-three elderly patients (>60 years) with chronic kidney disease (CKD) stages 3–5 underwent technetium-99 m-diethylenetriaminepentaacetic acid (Tc-99m-DTPA) radionuclide measurement of glomerular filtration rate (GFR). To predict GFR, estimation formulas [Cockcroft-Gault (CG), 6-variable Modification of Diet in Renal Disease (6-var-MDRD) and the corrected 24-hour creatinine clearance (24-h CCL) method] were used. Estimates of bias and precision were obtained to compare prediction equations of GFR with standard radionuclide measurement. Results In the present study, all the prediction equations overestimated the GFR measured with the radionuclide method. Six-var-MDRD and 24-h CCL methods correlated better with standard radionuclide measurements compared to the CG formula ( Rc of 0.53 and 0.50 vs. 0.41, respectively) as for GFR prediction, but they were still insufficiently accurate. Conclusion Glomerular filtration rate prediction equations correlate poorly with standard radionuclide measurements and their use may lead to late initialization of renal replacement therapy in elderly patients with ARD. Therefore, measurement by standard radionuclide method (Tc-99m-DTPA) is recommended to accurately assess GFR in elderly patients with ARD.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-010-9846-0