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NDT Advance Access originally published online on December 20, 2006
Nephrology Dialysis Transplantation 2007 22(3):960; doi:10.1093/ndt/gfl731
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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Email: 34989nfb{at}comb.es

Sir,

In agreement with your recent study ‘Prediction of glomerular filtration rate decline in diabetic subjects with impaired renal function’ and those of Rossing et al. [1], We believe the main interest in the use of the MDRD equation lies in the ambulatory monitoring of the decline of glomerular filtration in type 2 diabetic patients in chronic kidney disease stages 2 and 3 [2]. However, on the basis of our recent study [3], we would like to emphasize the existence of significant biases in the application of these formulae in advanced stages of renal disease and in extreme situations of nutritional status and age. Despite the currently recommended clinical guidelines derived from large original epidemiological studies, one of the main limitations in the application of these formulae is the personalized estimation of renal function in each patient.

Thus, to conclude, I believe the predictive equations to be useful tools for determining the degree of severity of kidney failure, particularly in epidemiologic studies, although they should be applied with a certain flexibility and for each individual patient when making important decisions such as initiating renal replacement treatment or prescribing potentially nephrotoxic drugs.

Conflict of interest statement. None declared.

Néstor Fontseré1, Jordi Bonal2 and Ramón Romero2

1Hospital de Terrassa
2Departments of Nephrology
University Hospital
Germans Trias i Pujol
Barcelona
Spain

References

  1. Rossing P, Rossing K, Gaede P, Pedersen O, Parving HH. (2006) Monitoring kidney function in type 2 diabetic patients with incipient and overt diabetic nephropathy. Diabetes Care 29:51024–1030.[Abstract/Free Full Text]
  2. Fontsere N, Salinas I, Bonal J, et al. (2006) Are prediction equations for glomerular filtration rate useful for the long-term monitoring of type 2 diabetic patients? Nephrol Dial Transplant 218:2152–2158.
  3. Fontsere N, Bonal J, Navarro M, et al. (2006) A comparison of prediction equations for estimating glomerular filtration rate in adult patients with chronic kidney disease stages 4–5. Effect of nutritional status and age. Nephron Clin Pract 104:4c160–c168 [Epub ahead of print].[CrossRef][Medline]

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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/3/960    most recent
gfl731v1
Right arrow Alert me when this article is cited
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Google Scholar
Right arrow Articles by Fontseré, N.
Right arrow Articles by Romero, R.
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Right arrow Articles by Fontseré, N.
Right arrow Articles by Romero, R.
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