Background: Purpose of our study was to find out correlation between estimated Glomerular Filtration Rate (GFR) by Modification of Diet in Renal Disease (MDRD) formula and Glomerular Filtration Rate by Cockcroft-Gault...Background: Purpose of our study was to find out correlation between estimated Glomerular Filtration Rate (GFR) by Modification of Diet in Renal Disease (MDRD) formula and Glomerular Filtration Rate by Cockcroft-Gault equations, in patients with chronic kidney disease (CKD), and to see whether they can be used interchangeably. Methods: We conducted a cross section study of 70 patients presented to the nephrology clinic over a period of one year. We compared the Glomerular Filtration Rate by these two formulas in five stages of Chronic Kidney Disease. Abbreviated 4 variable Modification of Diet in Renal Disease formula was used.Results: Age range was 15 - 79 years;Male 49%, Female 51%. The correlation (r) between eGFR by MDRD and eGFR by Cockcroft-Gault equation for CKD stages 1 to 5 was 0.64;0.31;0.32;0.67;and 0.45 respectively. The correlation (r) between creatinine clearance by 24 hour urine collection and MDRD formula was 0.84 (P: 0.001). The correlation (r) between creatinine clearance by 24 hour urine collection Cockcroft-Gault equation was 0.79 (P: 0.001). Conclusion: We conclude that Cockcroft-Gault equation correlates best with MDRD formula at CKD stages 4 and one. Cockcroft-Gault equation underestimated eGFR in stages 1, 2 and 3 of chronic Kidney Disease.展开更多
The Cockcroft-Gault(CG) equation has become perhaps the most popular practical approach for estimating renal function among health care professionals. Despite its widespread use, clinicians often overlook not only the...The Cockcroft-Gault(CG) equation has become perhaps the most popular practical approach for estimating renal function among health care professionals. Despite its widespread use, clinicians often overlook not only the limitations of the original serum creatinine(SCr) based equation, but also may not appreciate the validity of the many variations used to compensate for these limitations. For cirrhotic patients in particular, the underlying pathophysiology of the disease contributes to a falsely low SCr, thereby overestimating renal function with use of the CG equation in this population. We reviewed the original CG trial from 1976 along with data surrounding clinician specific alterations to the CG equation that followed through time. These alterations included different formulas for body weight in obese patients and the "rounding up" approach in patients with low SCr. Additionally, we described the pathophysiology and hemodynamic changes that occur in cirrhosis; and reviewed several studies that attempted to estimate renal function in this population. The evidence we reviewed regarding the most accurate manipulation of the original CG equation to estimate creatinine clearance(Cr Cl) was inconclusive. Unfortunately, the homogeneity of the patient population in the original CG trial limited its external validity. Elimination of body weight in the CG equation actually produced the estimate closest to the measure Cr Cl. Furthermore, "rounding up" of SCr values often underestimated Cr Cl. This approach could lead to suboptimal dosing of drug therapies in patients with low SCr. In cirrhotic patients, utilization of SCr based methods overestimated true renal function by about 50% in the literature we reviewed.展开更多
身为服装设计师,创作灵感消失殆尽,无疑是极大的致命伤,然而在被喻为时装界顽童的 Jean Paul Gaultier 的身上,绝对不会发生此状况。其设计领域之中完全没有界限,只有不断的创新,从他不拘一格的设计便可见一斑,你永远无法猜透他葫芦里...身为服装设计师,创作灵感消失殆尽,无疑是极大的致命伤,然而在被喻为时装界顽童的 Jean Paul Gaultier 的身上,绝对不会发生此状况。其设计领域之中完全没有界限,只有不断的创新,从他不拘一格的设计便可见一斑,你永远无法猜透他葫芦里卖的什么药,还将带给世人怎样的惊世奇作……展开更多
目的:以99mTc-DPTA血浆清除率为标准,对24h内生肌酐清除率(Ccr)、Cockcroft-Gault(CG)方程和简化MDRD(modification of diet in renal disease)方程进行比较,评价三种方程在慢性肾脏疾病(CKD)患者中的应用。方法:选择139例各种慢性肾脏...目的:以99mTc-DPTA血浆清除率为标准,对24h内生肌酐清除率(Ccr)、Cockcroft-Gault(CG)方程和简化MDRD(modification of diet in renal disease)方程进行比较,评价三种方程在慢性肾脏疾病(CKD)患者中的应用。方法:选择139例各种慢性肾脏疾病患者,将Ccr、CG方程和简化MDRM方程估算的肾小球滤过率(GFR)用体表面积(BSA)标准化,与BSA标准化的99mTc-DTPA测得的GFR(99mTc-GFR)在不同CKD分期进行比较。结果:CKD第一至第五期:Ccr与99mTc-GFR相关系数r分别为:0.79、0.71、0.64、0.59、0.52;Ccr在ROC曲线下面积平均为0.79。CG-GFR与99mTc-GFR相关系数r分别为:0.85、0.78、0.72、0.67、0.61;CG-GFR在ROC曲线下面积平均为0.83。MDRD-GFR与99mTc-GFR相关系数r分别为:0.83、0.76、0.69、0.65、0.59;MDRD-GFR在ROC曲线下面积平均为0.82。在CKD不同分期三种方程的GFR估算值与99mTc-GFR差异均有显著意义(P均<0.001)。结论:三种方程的GFR估算值与99mTc-GFR均有较好的相关性和ROC曲线下面积,以CG方程最好,其次为简化MDRD方程,Ccr最低,但三种方程估算值与99mTc-GFR测定值差异均有显著意义。上述方程直接应用于我国CKD患者时,应对其进行适当修正。展开更多
文摘Background: Purpose of our study was to find out correlation between estimated Glomerular Filtration Rate (GFR) by Modification of Diet in Renal Disease (MDRD) formula and Glomerular Filtration Rate by Cockcroft-Gault equations, in patients with chronic kidney disease (CKD), and to see whether they can be used interchangeably. Methods: We conducted a cross section study of 70 patients presented to the nephrology clinic over a period of one year. We compared the Glomerular Filtration Rate by these two formulas in five stages of Chronic Kidney Disease. Abbreviated 4 variable Modification of Diet in Renal Disease formula was used.Results: Age range was 15 - 79 years;Male 49%, Female 51%. The correlation (r) between eGFR by MDRD and eGFR by Cockcroft-Gault equation for CKD stages 1 to 5 was 0.64;0.31;0.32;0.67;and 0.45 respectively. The correlation (r) between creatinine clearance by 24 hour urine collection and MDRD formula was 0.84 (P: 0.001). The correlation (r) between creatinine clearance by 24 hour urine collection Cockcroft-Gault equation was 0.79 (P: 0.001). Conclusion: We conclude that Cockcroft-Gault equation correlates best with MDRD formula at CKD stages 4 and one. Cockcroft-Gault equation underestimated eGFR in stages 1, 2 and 3 of chronic Kidney Disease.
文摘The Cockcroft-Gault(CG) equation has become perhaps the most popular practical approach for estimating renal function among health care professionals. Despite its widespread use, clinicians often overlook not only the limitations of the original serum creatinine(SCr) based equation, but also may not appreciate the validity of the many variations used to compensate for these limitations. For cirrhotic patients in particular, the underlying pathophysiology of the disease contributes to a falsely low SCr, thereby overestimating renal function with use of the CG equation in this population. We reviewed the original CG trial from 1976 along with data surrounding clinician specific alterations to the CG equation that followed through time. These alterations included different formulas for body weight in obese patients and the "rounding up" approach in patients with low SCr. Additionally, we described the pathophysiology and hemodynamic changes that occur in cirrhosis; and reviewed several studies that attempted to estimate renal function in this population. The evidence we reviewed regarding the most accurate manipulation of the original CG equation to estimate creatinine clearance(Cr Cl) was inconclusive. Unfortunately, the homogeneity of the patient population in the original CG trial limited its external validity. Elimination of body weight in the CG equation actually produced the estimate closest to the measure Cr Cl. Furthermore, "rounding up" of SCr values often underestimated Cr Cl. This approach could lead to suboptimal dosing of drug therapies in patients with low SCr. In cirrhotic patients, utilization of SCr based methods overestimated true renal function by about 50% in the literature we reviewed.
文摘目的:以99mTc-DPTA血浆清除率为标准,对24h内生肌酐清除率(Ccr)、Cockcroft-Gault(CG)方程和简化MDRD(modification of diet in renal disease)方程进行比较,评价三种方程在慢性肾脏疾病(CKD)患者中的应用。方法:选择139例各种慢性肾脏疾病患者,将Ccr、CG方程和简化MDRM方程估算的肾小球滤过率(GFR)用体表面积(BSA)标准化,与BSA标准化的99mTc-DTPA测得的GFR(99mTc-GFR)在不同CKD分期进行比较。结果:CKD第一至第五期:Ccr与99mTc-GFR相关系数r分别为:0.79、0.71、0.64、0.59、0.52;Ccr在ROC曲线下面积平均为0.79。CG-GFR与99mTc-GFR相关系数r分别为:0.85、0.78、0.72、0.67、0.61;CG-GFR在ROC曲线下面积平均为0.83。MDRD-GFR与99mTc-GFR相关系数r分别为:0.83、0.76、0.69、0.65、0.59;MDRD-GFR在ROC曲线下面积平均为0.82。在CKD不同分期三种方程的GFR估算值与99mTc-GFR差异均有显著意义(P均<0.001)。结论:三种方程的GFR估算值与99mTc-GFR均有较好的相关性和ROC曲线下面积,以CG方程最好,其次为简化MDRD方程,Ccr最低,但三种方程估算值与99mTc-GFR测定值差异均有显著意义。上述方程直接应用于我国CKD患者时,应对其进行适当修正。
