Comparative performance of four equations estimating glomerular filtration rate in adult Chinese diabetics

Background: The Cockcroft-Gault equation, abbreviated Modification of Diet in Renal Disease (MDRD) equation, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and improved abbreviated MDRD equation were used to evaluate renal function in diabetic patients. However, little is known regarding their applicability and precision in Chinese diabetic patients. Aim: To compare the accuracy of four methods evaluating Chinese diabetic patients' renal function. Materials and methods: This study included 329 Chinese diabetic patients. Standard GFR (sGFR) was measured via (99)mTc-DTPA dynamic renal imaging. Estimated GFR (eGFR) was calculated by four equations separately. Applicability of these four equations in Chinese diabetic patients was determined by correlation studies, agreement test, and receiver operating characteristic (ROC) curves. Results: For Chinese diabetic patients, four methods assessing eGFR correlated well with sGFR. Overall, eGFR calculated via improved abbreviated MDRD had less bias and greater accuracy than the other algorithms estimating GFR (p <= 0.01). For patients with sGFR >= 260 ml/min/1.73 m(2), all four equations significantly underestimated actual GFR, with the improved abbreviated MDRD equation best approximating actual GFR (p <= 0.01). Conversely, in patients with sGFR<60 ml/min/1.73 m(2), all four equations overestimated actual GFR; GFR(improved MDRD) was relatively the most accurate (p <= 0.01). Conclusions: While all four equations were inaccurate, the improved abbreviated MDRD equation best diagnosed and stratified renal failure in Chinese diabetic patients. (C) 2013, Editrice Kurtis