Time to change the glomerular filtration rate estimating formula in primary care?

Eur J Intern Med. 2012 Jun;23(4):355-7. doi: 10.1016/j.ejim.2012.01.001. Epub 2012 Jan 28.


Background: The most commonly used equation for estimated glomerular filtration rate (eGFR) is nowadays the four-variable Modification of Diet in Renal Disease (MDRD) equation. This formula was derived from patients with non-diabetic chronic kidney disease (CKD) with mean GFR 40 ml/min.

Methods: We compared the MDRD study equation and the recently developed Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation by applying the two formulas in 1747 middle-aged cardiovascular risk persons in primary care.

Results: The prevalence of renal insufficiency defined as eGFR<60 ml/min was 6.7% (95% CI 5.6-8.0) according to the MDRD formula, and 3.6% (95% CI 2.8-4.6) according to the CKD-EPI formula. The subjects who were classified as having CKD according to the MDRD equation, but no-CKD according to the CKD-EPI formula, were mostly women (86%) and slightly younger than the subjects having CKD according to both formulas.

Conclusion: The characteristics of the subjects commonly treated in primary care resemble more closely the population from which the CKD-EPI than the MDRD study equation was derived from. Thus, we suppose that in general practice, the CKD-EPI equation is more suitable for estimating renal function than the MDRD equation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney Function Tests / standards
  • Male
  • Middle Aged
  • Primary Health Care
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / physiopathology
  • Reproducibility of Results
  • Risk Assessment
  • Sex Factors