Accuracy of the methods used to estimate glomerular filtration rate compared to 24-hour urinary creatinine clearance in patients with chronic spinal cord injury


Hazer B., ÖNDER F. O. , Metli N. B. , Aslan S. B. , Yalcin E., Akyuz M.

JOURNAL OF SPINAL CORD MEDICINE, 2021 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2021
  • Doi Number: 10.1080/10790268.2021.1975084
  • Title of Journal : JOURNAL OF SPINAL CORD MEDICINE
  • Keywords: Cockcroft-Gault creatinine clearance, Modification of Diet in Renal Disease equation, Chronic Kidney Disease Epidemiology Collaboration equation, Mayo Clinic Quadratic equation, Spinal cord injury, Glomerular filtration rate, SERUM CYSTATIN-C, RENAL-FUNCTION, EQUATION, DISEASE, DIET

Abstract

Objective To compare the accuracy of glomerular filtration rate (GFR) estimation by 24-hour urinary creatinine clearance with GFR estimation by the Modification of Diet in Renal Disease (MDRD) equation, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, the Mayo Clinic Quadratic equation (MCQE), and the modified Cockcroft-Gault formula in patients with spinal cord injury (SCI). Design Cross-sectional study. Participants Fifty-nine consecutive subjects, who were admitted to our hospital SCI rehabilitation and no additional acute medical disorders, were enrolled in this study. A 24-hour urine sample was collected for the determination of 24-hour urinary creatinine clearance, which was assumed as the standard technique for estimation of the GFR. The accuracy of several estimation formulas includes the 4-variable MDRD equation, the 6-variable MDRD equation, the Cockcroft and Gault equation, the CKD-EPI equation, and the MCQE. Results GFRs calculated by the Cockcroft-Gault equation and 4-variable MDRD were significantly different from the 24-hour urinary creatinine clearance, whereas there were no significant differences in GFRs calculated by CKD-EPI (P = 1.000), Mayo Clinic Quadratic formula (P = 0.794), and 6-variable MDRD equations (P = 0.435) and 24-hour urinary creatinine clearance. Both the 6-variable MDRD equation and CKD-EPI were accurate within +/- 20 of the reference methods in 52.54% of the subjects. Conclusions Among the methods used for estimation of the GFR including the 4- and 6-variable MDRD, the CKD-EPI, the modified Cockcroft-Gault equation, and the MCQE, the 6-variable MDRD equation and the CKD-EPI demonstrated best performance to estimate the GFR. However, none of the formulas were sufficient to estimate the GFR in SCI patients accurately.