The Chinese version of the modification of diet in renal disease (MDRD) equation is a superior screening tool for chronic kidney disease among middle-aged Taiwanese than the original MDRD and Cockcroft-Gault equations

Biomed J. Nov-Dec 2014;37(6):398-405. doi: 10.4103/2319-4170.132886.

Abstract

Background: Three equations have been often used to estimate glomerular filtration rate (GFR), namely, Modification of Diet in Renal Disease (MDRD), MDRD for Chinese (MDRDc), and Cockcroft-Gault (CG), for the purpose of screening individuals with chronic kidney disease (CKD). However, neither of these equations has been tested in a large Asian population. The aim of this study was to determine which equations were suitable for screening CKD in a large Taiwanese population.

Methods: The applicability of the three equations was analyzed among 32,542 participants of a health examination at Chang Gung Memorial Hospital (CGMH), Taiwan, between 2005 and 2007.

Results: Estimated glomerular filtration rate (eGFR)-MDRDc obtained the highest estimate of GFR (mean 101.5 ± 19.2 ml/min/1.73 m 2 ), followed by eGFR-MDRD (mean 83.8 ± 15.8 ml/min/1.73 m 2 ) and eGFR-CG (mean 79.4 ± 29.1 ml/min/1.73 m 2 ). The prevalence of CKD stage 3-5 was 1.9%, 5.1%, and 25.5% according to MDRDc, MDRD and CG equations, respectively. With respect to CKD staging, the agreement between eGFR-MDRDc and eGFR-CG (weighted kappa, k = 0.22) and that between eGFR-MDRD and eGFR-CG (weighted k = 0.30) was poor. Both the original MDRDc and MDRD indicated that subjects with risk factors for CKD had significantly lower eGFR and higher odds ratios for stage 3-5 disease than those without. Paradoxically, the mean eGFR-CG (or odds ratios) was higher (or lower) in subjects with hyperuricemia, hypertension, obesity, or metabolic syndrome than those without these risk factors.

Conclusions: The use of the CG equation in the Taiwanese population is inappropriate for screening individuals with CKD, and the MDRDc equation seems to be better for Taiwanese population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asian Continental Ancestry Group
  • Creatinine / metabolism
  • Diet
  • Female
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology*
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / epidemiology*
  • Prevalence
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / metabolism
  • Risk Factors
  • Taiwan

Substances

  • Creatinine