MDRD versus CKD-EPI equation to estimate glomerular filtration rate in kidney transplant recipients

Ingrid Masson, Martin Flamant, Nicolas Maillard, Andrew D. Rule, François Vrtovsnik, Marie Noëlle Peraldi, Lise Thibaudin, Etienne Cavalier, Emmanuelle Vidal-Petiot, Christine Bonneau, Olivier Moranne, Eric Alamartine, Christophe Mariat, Pierre Delanaye

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Abstract

BACKGROUND: The new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-based equation was developed to address the systematic underestimation of the glomerular filtration rate (GFR) by the Modification of Diet in Renal Disease (MDRD) Study equation in patients with a relatively well-preserved kidney function. The performance of the new equation for kidney transplant recipients is discussed. METHODS: We analyzed the performances of the CKD-EPI equation in comparison with the MDRD Study equation in 825 stable kidney transplant recipients. Bias, precision, and accuracy within 30% of true GFR were determined. GFR was measured by urinary clearance of inulin (n=488) and plasma clearance of 51Cr-EDTA (n=337). RESULTS: Mean measured GFR (mGFR) was 50±19 mL/min/1.73 m2. On the whole cohort, bias was significantly lower for MDRD Study equation compared with CKD-EPI creatinine. This superiority translates into a better accuracy (80% and 74% for the MDRD and CKD-EPI creatinine, respectively). The best performance of the MDRD Study equation is confirmed both in the subgroups of patients with mGFR <60 mL/min/1.73 m2 and between 60 and 90 mL/min/1.73 m2. For mGFR >90 mL/min/1.73 m2, there were no significant differences between the two equations in terms of performance. CONCLUSIONS: The CKD-EPI creatinine equation does not offer a better GFR prediction in renal transplant patients compared with the MDRD Study equation, even in the earlier CKD stages.

Original languageEnglish (US)
Pages (from-to)1211-1217
Number of pages7
JournalTransplantation
Volume95
Issue number10
DOIs
StatePublished - May 27 2013

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Keywords

  • CKD-EPI
  • Glomerular filtration rate
  • Renal transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Masson, I., Flamant, M., Maillard, N., Rule, A. D., Vrtovsnik, F., Peraldi, M. N., Thibaudin, L., Cavalier, E., Vidal-Petiot, E., Bonneau, C., Moranne, O., Alamartine, E., Mariat, C., & Delanaye, P. (2013). MDRD versus CKD-EPI equation to estimate glomerular filtration rate in kidney transplant recipients. Transplantation, 95(10), 1211-1217. https://doi.org/10.1097/TP.0b013e318288caa6