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NDT Advance Access originally published online on October 30, 2007
Nephrology Dialysis Transplantation 2008 23(1):409-410; doi:10.1093/ndt/gfm602
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© The Author [2007]. 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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Sir,

We thank Drs Maaravi et al. for their interest in our paper. We acknowledge the recent study by Rule et al., which reports that the MDRD equation underestimates GFR in healthy individuals by 29%, but only by 6.2% among patients with CKD [1]. Our study population included only subjects with a GFR <60 ml/min per 1.73 m2 fall, well within the range that the MDRD equation has been validated for [2], and as such our study should be robust enough for analysis. GFR was a predictor for the presence of coronary artery calcification (odds ratio 1.11, 95% CI 1.02–1.20) in our binary logistic regression analysis of subjects with CKD without diabetes. We fail to see how reclassifying our study patients would affect the prevalence rates of CAC, given that the groups were so equally matched (GFR 36 ml/min per 1.73 m2 with and without diabetes). Additionally our study population was relatively young (average age 51 years) compared to Dr Maaravi's study, which included only individuals aged 70 years at initiation. However, in future studies on either older subjects or patients with CKD stages 1 and 2, we will certainly consider comparing The Mayo Clinic formula to both the Modification of Diet in Renal Disease and Cockcroft–Gault equations.

Conflict of interest statement. None declared.

Christine Porter, Aristeidis Stavroulopoulos, Simon D. Roe, Kate Pointon and Michael J. D. Cassidy

References

  1. Rule AD, Larson TS, Bergstralh EJ, Slezak JM, Jacobsen SJ, Cusio FG. Using serum creatinine to estimate glomerular filtration rate: Accuracy in good health and in chronic kidney disease. Ann Intern Med (2004) 141:929–937.[Abstract/Free Full Text]
  2. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. Amore accurate method to estimate glomerular filtration rate from serum creatinine. A new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med (1999) 130:461–470.[Abstract/Free Full Text]

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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:
23/1/409-a    most recent
gfm602v1
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