Back to Search
Start Over
Does eGFR improve the diagnostic capability of S-Creatinine concentration results? A retrospective population based study
- Source :
- Karolinska Institutet, International Journal of Medical Sciences
- Publication Year :
- 2008
- Publisher :
- Ivyspring International Publisher, 2008.
-
Abstract
- The use of MDRD-eGFR to diagnose Chronic Kidney Disease (CKD) is based on the assumption that the algorithm will minimize the influence of age, gender and ethnicity that is observed in S-Creatinine concentration and thus allow a single cut-off at which further diagnostic and therapeutic actions should be considered. This hypothesis is tested in a retrospective analysis of outpatients (N=93,404) and hospitalised (N=35,572) patients in UK and Sweden, respectively. An algorithm based on the same model as the MDRD-eGFR algorithm was derived from simultaneously measured S-Creatinine concentrations and Iohexol GFR in a subset of 565 patients. The combined uncertainty of using this algorithm was estimated to about 15 % which is about three times that of the S-Creatinine concentration results. The diagnostic performance of S-Creatinine concentration was evaluated using the Iohexol clearance as the reference procedure. It was shown that the diagnostic capacity of MDRD-eGFR, as it stands, has no added value compared to S-Creatinine. The gender and age differences of the S-Creatinine concentrations in the dataset persist after applying the MDRD-eGFR algorithm. Thus, a general use of the MDRD-eGFR does not seem justified. Furthermore the claim that the eGFR is adjusted for body area is misleading; the algorithm does not include any body size marker. It is thus a dangerous marker for guiding drug administration.
- Subjects :
- Male
Contrast Media
urologic and male genital diseases
inpatients
Cohort Studies
chemistry.chemical_compound
Reference Values
Diagnosis
Outpatients
Aged, 80 and over
General Medicine
Middle Aged
female genital diseases and pregnancy complications
Creatinine
Female
Algorithms
Research Paper
Glomerular Filtration Rate
Cohort study
medicine.drug
Adult
medicine.medical_specialty
Metabolic Clearance Rate
Iohexol
Renal function
Sensitivity and Specificity
Age Distribution
Internal medicine
CKD
medicine
Humans
Sex Distribution
Aged
Retrospective Studies
Sweden
algorithm
business.industry
Drug administration
Retrospective cohort study
medicine.disease
United Kingdom
Surgery
Population based study
ROC Curve
chemistry
Kidney Failure, Chronic
business
Kidney disease
Subjects
Details
- ISSN :
- 14491907
- Database :
- OpenAIRE
- Journal :
- International Journal of Medical Sciences
- Accession number :
- edsair.doi.dedup.....eecedd0be6fdf249bc2e01520ace4787