Author(s): D S S K Raju, D L Lalitha, Patnala Kiranmayi
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Staging of Chronic kidney disease (CKD) is important not only for proper evaluation and treatment but also to consider the need for dialysis. This staging depends on GFR value which is measured by radio labeled substances and 24 hours urine creatinine clearance but these have their own limitations. Serum creatinine based estimated GFR (eGFR) is more convenient and cost effective. Therefore this study was undertaken to estimate GFR by using Cockcroft-Gault formula, MDRD equation and MCQE in controls and CKD patients. The study comprised of 123 healthy individuals as control group and 128 patients with evidence of CKD. In control group, MCQE provided a reasonable value of eGFR in all age groups when compared with CG and MDRD formulae. Besides this, MDRD provided a higher value of eGFR than CG in the age group of above 60 years. CG and MDRD placed in, around 50% of the control population under less than<90ml/min/1.73m 2 grading them all as stage 2 mostly and only a few as stage 3. MCQE placed only 10% of healthy individuals under stage 2. Therefore, MCQE more appropriately estimates GFR in control group than CG and MDRD. There is a significant decrease of estimated GFR by three formulae in CKD group when compared with control group. In CKD group, very few cases are under stage 2 whereas stage 3 comprises of 28.2%, 26% and 23% according to CG, MDRD and MCQE respectively. The distribution of stage 4 includes 32%, 28.2% and 27% and stage 5 includes 39%, 45.3% and 48% according to CG, MDRD and MCQE respectively. This reflects the fact that the GFR is underestimated in CKD group and the same might have happened in the controls too. However, with some reservation, MCQE in control and MDRD and MCQE in cases are found to be satisfactory in staging CKD in the present study.
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This article was published in Asian Journal of Pharmaceutical and Clinical Research
and referenced in Journal of Clinical Research & Bioethics