Nephrol Dial Transplant (2003) 18: 1307-1310
© 2003 European Renal Association-European Dialysis and Transplant Association
Predicted creatinine clearance to evaluate glomerular filtration rate in black Caribbean subjects
Département de Néphrologie et d'Hypertension artérielle, Hôpital E. Herriot, Lyon, France
Background and methods. Although Caribbean people have been a lesser-studied ethnic group than other populations, they have a high burden of hypertension and renal disease. Because Caribbean people have a greater muscle mass than Caucasians, this study examined the accuracy of creatinine-based estimates (creatinine clearance; Ccr and Cockcroft–Gault formula; C-G Cl) of glomerular filtration rate (GFR) in 38 Caribbeans who were matched for age, gender, and GFR, with 38 Caucasian subjects. Patients were considered black Caribbean if at least one of two parents was of black Caribbean origin. GFR values ranging from 5 to 140 ml/min/1.73 m2 were measured by inulin clearance. Results were compared using linear correlations and the Bland and Altman methodology to provide better estimates of value dispersion.
Results. Correlation coefficients between C-G Cl and GFR were highly significant in both black Caribbean subjects (r=0.83, P<0.001) and Caucasians (r=0.84, P<0.001). Similar coefficients were obtained between Ccr and GFR (r=0.89, P<0.001 and r=0.90, P<0.001, respectively). In spite of these strong correlations, the Bland and Altman representation highlighted huge intra-individual variations in GFR estimation by C-G Cl and by Ccr in both ethnic groups. The underestimation of GFR by C-G Cl was significant in black Caribbeans (-8.6±20 ml/min/1.73 m2, P<0.001) but not in Caucasians (-5.6±20.7 ml/min/1.73 m2). Ccr overestimation of GFR was significant both in Caribbeans (8.7±16.8 ml/min/1.73 m2, P<0.001) and in Caucasians (7.2±15.7 ml/min/1.73 m2, P<0.01).
Conclusions. The C-G formula for estimating GFR yields similar clinical values in black Caribbeans and in Caucasians, but the same limitations were observed in both ethnic groups.
Keywords: black patients; Cockcroft–Gault; creatinine; GFR; renal function
Correspondence and offprint requests to: J. P. Fauvel, Département de Néphrologie, Hôpital Edouard Herriot, 69437 Lyon Cedex 03, France. Email: jean-pierre.fauvel{at}chu-lyon.fr
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  R. Botev, J.-P. Mallie, C. Couchoud, O. Schuck, J.-P. Fauvel, J. F.M. Wetzels, N. Lee, N. G. De Santo, and M. Cirillo Estimating Glomerular Filtration Rate: Cockcroft-Gault and Modification of Diet in Renal Disease Formulas Compared to Renal Inulin Clearance Clin. J. Am. Soc. Nephrol., May 1, 2009; 4(5): 899 - 906. [Abstract] [Full Text] [PDF]
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