Nephrology Dialysis Transplantation, Vol 14, Issue 3 615-619, Copyright © 1999 by Oxford University Press
S Nielsen, M Rehling, A Schmitz and C Mogensen
Background. Rapid estimation of the renal function is
widely used in clinical practice. Methods. The
validity of rapid estimation of renal function as well as long-term changes
in renal function from the Cockcroft-Gault formula for estimation of
creatinine clearance or from serum creatinine measurements was evaluated
against the 51Cr-EDTA plasma clearance technique in
36 type 2 diabetic patients with normal renal function followed for 5.2
(2.7-7.5) (mean (range) years. Results. Compared with
51Cr-EDTA plasma clearance the Cockcroft-Gault
formula significantly underestimated glomerular filtration rate by 21%. The
degree of underestimation was observed over the whole range of glomerular
filtration rate studied and increased with increasing levels of
isotopically measured glomerular filtration rates. Serum creatinine was not
significantly associated with glomerular filtration rate. the average
long-term change in renal function was significantly overestimated by the
Cockcroft-Gault formula (-2.8±2.3 ml/min/year) compared with the
measured rate (-1.5±2.5 ml/min/year)
P=0.002). The difference in change rate between the
two methods was highest when the measured fall rates were small and tended
to disappear in patients with faster fall rates. Changes in serum
creatinine correlated significantly, but imprecisely, with the rate of
decline of measured glomerular filtration rate
(r=-0.48, P=0.003). The
variability of the estimated fall rate of renal function was unacceptably
high for all approaches. Conclusion. Valid estimates
of glomerular filtration rate as well as the rate of change in glomerular
filtration rate cannot be obtained by estimation of creatinine clearance
from the Cockcroft-Gault formula or from serum creatinine concentration
measurements in type 2 diabetic patients with normal renal function.
Keywords: diabetic nephropathy; estimated creatinine
clearance; glomerular filtration rate; rate of decline of renal function;
serum creatinine
ORIGINAL ARTICLES
Validity of rapid estimation of glomerular filtration rate in type 2 diabetic patients with normal renal function
Medical Department M (Endocrinology and Diabetes), Department of Clinical Physiology and Nuclear Medicine, Arhus Kommunehospital, DK-8000 Arhus C, Denmark; Corresponding author
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