Estimation of Glomerular Filtration Rate in Diabetic Subjects
Estimation of Glomerular Filtration Rate in Diabetic Subjects Cockcroft formula or Modification of Diet in Renal Disease study equation? Vincent Rigalleau , MD, PHD 1 , Catherine Lasseur , MD 2 , Caroline Perlemoine , MD 1 , Nicole Barthe , PD 3 , C. Raffaitin , MD 1 , Chung Liu , MD 1 , Phillipe Ch...
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| Vydáno v: | Diabetes care Ročník 28; číslo 4; s. 838 - 843 |
|---|---|
| Hlavní autoři: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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American Diabetes Association
01.04.2005
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| ISSN: | 0149-5992, 1935-5548 |
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| Abstract | Estimation of Glomerular Filtration Rate in Diabetic Subjects
Cockcroft formula or Modification of Diet in Renal Disease study equation?
Vincent Rigalleau , MD, PHD 1 ,
Catherine Lasseur , MD 2 ,
Caroline Perlemoine , MD 1 ,
Nicole Barthe , PD 3 ,
C. Raffaitin , MD 1 ,
Chung Liu , MD 1 ,
Phillipe Chauveau , MD 2 ,
Laurence Baillet-Blanco , MD 1 ,
Marie-Christine Beauvieux , PD 1 ,
C. Combe , MD, PHD 2 and
Henri Gin , MD, PHD 1
1 Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France
2 Department of Nephrology, University Victor Segalen Bordeaux II, Bordeaux, France
3 Department of Nuclear Medicine, University Victor Segalen Bordeaux II, Bordeaux, France
Address correspondence and reprint requests to Vincent Rigalleau, Nutrition-Diabétologie, Hôpital Haut-Lévêque, Avenue de
Magellan, 33600 Pessac, France. E-mail: vincent.rigalleau{at}wanadoo.fr
Abstract
OBJECTIVE —The Cockcroft-Gault formula is recommended for the evaluation of renal function in diabetic patients. The more recent Modification
of Diet in Renal Disease (MDRD) study equation seems more accurate, but it has not been validated in diabetic patients. This
study compares the two methods.
RESEARCH DESIGN AND METHODS —In 160 diabetic patients, we compared the Cockcroft-Gault formula and MDRD equation estimations to glomerular filtration
rates (GFRs) measured by an isotopic method ( 51 Cr-EDTA) by correlation studies and a Bland-Altman procedure. Their accuracy for the diagnosis of moderately (GFR <60 ml ·
min −1 · 1.73 m −2 ) or severely (GFR <30 ml · min −1 · 1.73 m −2 ) impaired renal function were compared with receiver operating characteristic (ROC) curves.
RESULTS —Both the Cockcroft-Gault formula ( r = 0.74; P < 0.0001) and MDRD equation ( r = 0.81; P < 0.0001) were well correlated with isotopic GFR. The Bland-Altman procedure revealed a bias for the MDRD equation, which
was not the case for the Cockcroft-Gault formula. Analysis of ROC curves showed that the MDRD equation had a better maximal
accuracy for the diagnosis of moderate (areas under the curve [AUCs] 0.868 for the Cockcroft-Gault formula and 0.927 for the
MDRD equation; P = 0.012) and severe renal failure (AUC 0.883 for the Cockcroft-Gault formula and 0.962 for the MDRD equation; P = 0.0001). In the 87 patients with renal insufficiency, the MDRD equation estimation was better correlated with isotopic
GFR (Cockcroft-Gault formula r = 0.57; the MDRD equation r = 0.78; P < 0.01), and it was not biased as evaluated by the Bland-Altman procedure.
CONCLUSIONS —Although both equations have imperfections, the MDRD equation is more accurate for the diagnosis and stratification of renal
failure in diabetic patients.
AUC, area under the curve
ESRD, end-stage renal disease
GFR, glomerular filtration rate
MDRD, Modification of Diet in Renal Disease
ROC, receiver operating characteristic
Footnotes
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
Accepted December 20, 2004.
Received September 12, 2004.
DIABETES CARE |
|---|---|
| AbstractList | OBJECTIVE—The Cockcroft-Gault formula is recommended for the evaluation of renal function in diabetic patients. The more recent Modification of Diet in Renal Disease (MDRD) study equation seems more accurate, but it has not been validated in diabetic patients. This study compares the two methods.
RESEARCH DESIGN AND METHODS—In 160 diabetic patients, we compared the Cockcroft-Gault formula and MDRD equation estimations to glomerular filtration rates (GFRs) measured by an isotopic method (51Cr-EDTA) by correlation studies and a Bland-Altman procedure. Their accuracy for the diagnosis of moderately (GFR <60 ml · min−1 · 1.73 m−2) or severely (GFR <30 ml · min−1 · 1.73 m−2) impaired renal function were compared with receiver operating characteristic (ROC) curves.
RESULTS—Both the Cockcroft-Gault formula (r = 0.74; P < 0.0001) and MDRD equation (r = 0.81; P < 0.0001) were well correlated with isotopic GFR. The Bland-Altman procedure revealed a bias for the MDRD equation, which was not the case for the Cockcroft-Gault formula. Analysis of ROC curves showed that the MDRD equation had a better maximal accuracy for the diagnosis of moderate (areas under the curve [AUCs] 0.868 for the Cockcroft-Gault formula and 0.927 for the MDRD equation; P = 0.012) and severe renal failure (AUC 0.883 for the Cockcroft-Gault formula and 0.962 for the MDRD equation; P = 0.0001). In the 87 patients with renal insufficiency, the MDRD equation estimation was better correlated with isotopic GFR (Cockcroft-Gault formula r = 0.57; the MDRD equation r = 0.78; P < 0.01), and it was not biased as evaluated by the Bland-Altman procedure.
CONCLUSIONS—Although both equations have imperfections, the MDRD equation is more accurate for the diagnosis and stratification of renal failure in diabetic patients. Estimation of Glomerular Filtration Rate in Diabetic Subjects Cockcroft formula or Modification of Diet in Renal Disease study equation? Vincent Rigalleau , MD, PHD 1 , Catherine Lasseur , MD 2 , Caroline Perlemoine , MD 1 , Nicole Barthe , PD 3 , C. Raffaitin , MD 1 , Chung Liu , MD 1 , Phillipe Chauveau , MD 2 , Laurence Baillet-Blanco , MD 1 , Marie-Christine Beauvieux , PD 1 , C. Combe , MD, PHD 2 and Henri Gin , MD, PHD 1 1 Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France 2 Department of Nephrology, University Victor Segalen Bordeaux II, Bordeaux, France 3 Department of Nuclear Medicine, University Victor Segalen Bordeaux II, Bordeaux, France Address correspondence and reprint requests to Vincent Rigalleau, Nutrition-Diabétologie, Hôpital Haut-Lévêque, Avenue de Magellan, 33600 Pessac, France. E-mail: vincent.rigalleau{at}wanadoo.fr Abstract OBJECTIVE —The Cockcroft-Gault formula is recommended for the evaluation of renal function in diabetic patients. The more recent Modification of Diet in Renal Disease (MDRD) study equation seems more accurate, but it has not been validated in diabetic patients. This study compares the two methods. RESEARCH DESIGN AND METHODS —In 160 diabetic patients, we compared the Cockcroft-Gault formula and MDRD equation estimations to glomerular filtration rates (GFRs) measured by an isotopic method ( 51 Cr-EDTA) by correlation studies and a Bland-Altman procedure. Their accuracy for the diagnosis of moderately (GFR <60 ml · min −1 · 1.73 m −2 ) or severely (GFR <30 ml · min −1 · 1.73 m −2 ) impaired renal function were compared with receiver operating characteristic (ROC) curves. RESULTS —Both the Cockcroft-Gault formula ( r = 0.74; P < 0.0001) and MDRD equation ( r = 0.81; P < 0.0001) were well correlated with isotopic GFR. The Bland-Altman procedure revealed a bias for the MDRD equation, which was not the case for the Cockcroft-Gault formula. Analysis of ROC curves showed that the MDRD equation had a better maximal accuracy for the diagnosis of moderate (areas under the curve [AUCs] 0.868 for the Cockcroft-Gault formula and 0.927 for the MDRD equation; P = 0.012) and severe renal failure (AUC 0.883 for the Cockcroft-Gault formula and 0.962 for the MDRD equation; P = 0.0001). In the 87 patients with renal insufficiency, the MDRD equation estimation was better correlated with isotopic GFR (Cockcroft-Gault formula r = 0.57; the MDRD equation r = 0.78; P < 0.01), and it was not biased as evaluated by the Bland-Altman procedure. CONCLUSIONS —Although both equations have imperfections, the MDRD equation is more accurate for the diagnosis and stratification of renal failure in diabetic patients. AUC, area under the curve ESRD, end-stage renal disease GFR, glomerular filtration rate MDRD, Modification of Diet in Renal Disease ROC, receiver operating characteristic Footnotes A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Accepted December 20, 2004. Received September 12, 2004. DIABETES CARE |
| Author | Vincent Rigalleau Caroline Perlemoine Laurence Baillet-Blanco C. Combe Nicole Barthe Catherine Lasseur Marie-Christine Beauvieux Henri Gin C. Raffaitin Phillipe Chauveau Chung Liu |
| Author_xml | – sequence: 1 givenname: Vincent surname: Rigalleau fullname: Rigalleau, Vincent organization: Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France – sequence: 2 givenname: Catherine surname: Lasseur fullname: Lasseur, Catherine organization: Department of Nephrology, University Victor Segalen Bordeaux II, Bordeaux, France – sequence: 3 givenname: Caroline surname: Perlemoine fullname: Perlemoine, Caroline organization: Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France – sequence: 4 givenname: Nicole surname: Barthe fullname: Barthe, Nicole organization: Department of Nuclear Medicine, University Victor Segalen Bordeaux II, Bordeaux, France – sequence: 5 givenname: C. surname: Raffaitin fullname: Raffaitin, C. organization: Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France – sequence: 6 givenname: Chung surname: Liu fullname: Liu, Chung organization: Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France – sequence: 7 givenname: Phillipe surname: Chauveau fullname: Chauveau, Phillipe organization: Department of Nephrology, University Victor Segalen Bordeaux II, Bordeaux, France – sequence: 8 givenname: Laurence surname: Baillet-Blanco fullname: Baillet-Blanco, Laurence organization: Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France – sequence: 9 givenname: Marie-Christine surname: Beauvieux fullname: Beauvieux, Marie-Christine organization: Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France – sequence: 10 givenname: C. surname: Combe fullname: Combe, C. organization: Department of Nephrology, University Victor Segalen Bordeaux II, Bordeaux, France – sequence: 11 givenname: Henri surname: Gin fullname: Gin, Henri organization: Department of Nutrition and Diabetes, Hôpital Haut-Lévêque, Pessac, France |
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| Snippet | Estimation of Glomerular Filtration Rate in Diabetic Subjects
Cockcroft formula or Modification of Diet in Renal Disease study equation?
Vincent Rigalleau ,... OBJECTIVE—The Cockcroft-Gault formula is recommended for the evaluation of renal function in diabetic patients. The more recent Modification of Diet in Renal... |
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| Title | Estimation of Glomerular Filtration Rate in Diabetic Subjects |
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