AI Article Synopsis
- Guidelines recommend measuring glomerular filtration rate (GFR) using creatinine-based equations (CBE), but this study evaluates their accuracy compared to GFR measured with radionuclide imaging.
- In a sample of 421 patients, different CBE methods (MDRD-4, CKD-EPI, Cockcroft-Gault) produced similar average GFR values, but only about 29% of participants had a GFR indicating potential kidney issues.
- While there was good correlation among the CBE methods, the results showed low agreement with the radionuclide imaging measurements, indicating that CBE may not reliably reflect true GFR.
Article Abstract
Background: Guidelines recommend estimating glomerular filtration rate (GFR) using creatinine-based equations (CBE).
Aim: To evaluate the agreement between GFR measured using radionuclide imaging and estimated using creatinine-based equations.
Material And Methods: In 421 patients aged 54 ± 17 years (47% women) GFR was estimated using the MDRD-4, CKD-EPI and the body surface adjusted Cockroft Gault equation. GFR was also measured using a radionuclide imaging method with 99mTc-DTPA. The concordance between estimated and measured GFR was calculated using Lin's concordance coefficient and Bland and Altman plots.
Results: Average GFR values obtained with CKD-EPI, MDRD-4, body surface adjusted Cockroft Gault equation and 99mTc-DTPA imaging were 75.9 ± 26.6, 76.3 ± 28.8, 77.1 ± 31.6 and 77.9 ± 28.4 ml/min/1.73 m2, respectively. There was no significant difference in means and 29% of participants had a GFR < 60 ml/min/1.73 m2 by CKD-EPI. The correlation was good between equations, but acceptable when compared with the 99mTc-DTPA imaging. The weighted kappa between CBEs was good, but low when comparing CBEs with measured GFR. The Lin's concordance coefficient between estimated and measured GFR was low.
Conclusions: GFR measured by 99mTc-DTPA radionuclide imaging has a low correlation and poor concordance with estimations using CBE.
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| http://dx.doi.org/10.4067/S0034-98872021000100013 | DOI Listing |
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