Ethnic Coefficients for Glomerular Filtration Rate Estimation by the Modification of Diet in Renal Disease Study Equations in the Korean Population

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

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.

Related collections

Most cited references 23

Record: found
Abstract: found
Article: not found

Statistical methods for assessing agreement between two methods of clinical measurement.

J Bland, D Altman (1986)

In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.

0 comments Cited 2544 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Recommendations for improving serum creatinine measurement: a report from the Laboratory Working Group of the National Kidney Disease Education Program.

G. Myers (2006)

Reliable serum creatinine measurements in glomerular filtration rate (GFR) estimation are critical to ongoing global public health efforts to increase the diagnosis and treatment of chronic kidney disease (CKD). We present an overview of the commonly used methods for the determination of serum creatinine, method limitations, and method performance in conjunction with the development of analytical performance criteria. Available resources for standardization of serum creatinine measurement are discussed, and recommendations for measurement improvement are given. The National Kidney Disease Education Program (NKDEP) Laboratory Working Group reviewed problems related to serum creatinine measurement for estimating GFR and prepared recommendations to standardize and improve creatinine measurement. The NKDEP Laboratory Working Group, in collaboration with international professional organizations, has developed a plan that enables standardization and improved accuracy (trueness) of serum creatinine measurements in clinical laboratories worldwide that includes the use of the estimating equation for GFR based on serum creatinine concentration that was developed from the Modification of Diet in Renal Disease (MDRD) study. The current variability in serum creatinine measurements renders all estimating equations for GFR, including the MDRD Study equation, less accurate in the normal and slightly increased range of serum creatinine concentrations [<133 micromol/L (1.5 mg/dL)], which is the relevant range for detecting CKD [<60 mL.min(-1).(1.73 m2)(-1)]. Many automated routine methods for serum creatinine measurement meet or exceed the required precision; therefore, reduction of analytical bias in creatinine assays is needed. Standardization of calibration does not correct for analytical interferences (nonspecificity bias). The bias and nonspecificity problems associated with some of the routine methods must be addressed.

0 comments Cited 235 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease.

Enyu Imai, Toshiki Moriyama, Sadayoshi Ito … (2007)

Accurate estimation of the glomerular filtration rate (GFR) is crucial for the detection of chronic kidney disease (CKD). In clinical practice, GFR is estimated from serum creatinine using the Modification of Diet in Renal Disease (MDRD) study equation or the Cockcroft-Gault (CG) equation instead of the time-consuming method of measured clearance for exogenous markers such as inulin. In the present study, the equations originally developed for a Caucasian population were tested in Japanese CKD patients, and modified with the Japanese coefficient determined by the data. The abbreviated MDRD study and CG equations were tested in 248 Japanese CKD patients and compared with measured inulin clearance (Cin) and estimated GFR (eGFR). The Japanese coefficient was determined by minimizing the sum of squared errors between eGFR and Cin. Serum creatinine values of the enzyme method in the present study were calibrated to values of the noncompensated Jaffé method by adding 0.207 mg/dl, because the original MDRD study equation was determined by the data for serum creatinine values measured by the noncompensated Jaffé method. The abbreviated MDRD study equation modified with the Japanese coefficient was validated in another set of 269 CKD patients. There was a significant discrepancy between measured Cin and eGFR by the 1.0xMDRD or CG equations. The MDRD study equation modified with the Japanese coefficient (0.881xMDRD) determined for Japanese CKD patients yielded lower mean difference and higher accuracy for GFR estimation. In particular, in Cin 30-59 ml/min per 1.73 m(2), the mean difference was significantly smaller with the 0.881xMDRD equation than that with the 1.0xMDRD study equation (1.9 vs 7.9 ml/min per 1.73 m(2); P < 0.01), and the accuracy was significantly higher, with 60% vs 39% of the points deviating within 15%, and 97% vs 87% of points within 50%, respectively (both P < 0.01). Validation with the different data set showed the correlation between eGFR and Cin was better with the 0.881xMDRD equation than with the 1.0xMDRD study equation. In Cin less than 60 ml/min per 1.73 m(2), the accuracy was significantly higher, with 85% vs 69% of the points deviating within 50% (P < 0.01), respectively. The mean difference was also significantly smaller (P < 0.01). However, GFR values calculated by the 0.881xMDRD equation were still underestimated in the range of Cin over 60 ml/min per 1.73 m(2). Although the Japanese coefficient improves the accuracy of GFR estimation of the original MDRD study equation, a new equation is needed for more accurate estimation of GFR in Japanese patients with CKD stages 3 and 4.

0 comments Cited 109 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): J Korean Med Sci

Journal ID (publisher-id): JKMS

Title: Journal of Korean Medical Science

Publisher: The Korean Academy of Medical Sciences

ISSN (Print): 1011-8934

ISSN (Electronic): 1598-6357

Publication date (Print): November 2010

Publication date (Electronic): 26 October 2010

Volume: 25

Issue: 11

Pages: 1616-1625

Affiliations

[1 ]Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

[2 ]Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University, Seoul, Korea.

[3 ]Department of Clinical Pharmacology, Seoul National University College of Medicine, Seoul, Korea.

[4 ]Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Korea.

Author notes

Address for Correspondence: Yon Su Kim, M.D. Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehang-no, Jongno-gu, Seoul 110-744, Korea. Tel: +82.2-2072-2264, Fax: +82.2-745-2264, yonsukim@ 123456snu.ac.kr

^*Chung Sik Lee and Ran-hui Cha contributed equally to this work.

Article

DOI: 10.3346/jkms.2010.25.11.1616

PMC ID: 2966999

PubMed ID: 21060751

SO-VID: 7157b1e3-3c2c-4979-823c-7e95be9cd51e

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Ethnic Coefficients for Glomerular Filtration Rate Estimation by the Modification of Diet in Renal Disease Study Equations in the Korean Population

Read this article at

Abstract

Related collections

Coronaviruses, COVID-19 and SARS-CoV-2

Most cited references 23

Statistical methods for assessing agreement between two methods of clinical measurement.

Recommendations for improving serum creatinine measurement: a report from the Laboratory Working Group of the National Kidney Disease Education Program.

Estimation of glomerular filtration rate by the MDRD study equation modified for Japanese patients with chronic kidney disease.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 310

Cited by 49

Most referenced authors 651