Original InvestigationPathogenesis and Treatment of Kidney DiseaseAccuracy of the MDRD (Modification of Diet in Renal Disease) Study and CKD-EPI (CKD Epidemiology Collaboration) Equations for Estimation of GFR in the Elderly
Section snippets
Participant Selection
Participants were either patients known to the Kent Kidney Care Centre or residents of the local population. The latter were recruited through a variety of means, including the researchers attending discussion groups in Age Concern centers, golf clubs, Rotary clubs, and residential care homes, and through advertising the study by media briefings in hospital newsletters, local newspapers, and radio stations. Overall, 38% of participants were recruited through nephrology clinics, and 62%, through
Results
A total of 398 individuals were recruited to the study. An additional 27 individuals initially agreed to participate but subsequently withdrew, for reasons including intercurrent illness at the time of the scheduled test, refusal for participation from family members, and inability to provide alternative arrangements for their dependents. Three individuals of African-Caribbean ethnicity and one amputee were excluded from the final analyses on the basis that as subgroups, they were too small to
Discussion
We present a large prospective evaluation of the performance of contemporary GFR estimating equations in older people. Overall, our data suggest that these equations perform as well in the older population as in younger people and that there may be marginal benefits in using one of the CKD-EPI equations compared to the MDRD Study equation.
Several studies have been undertaken directly comparing the MDRD Study and CKD-EPIcr equations: a variety of statistical approaches have been used. In this
Acknowledgements
We thank the staff of Clinical Biochemistry and The Kent Kidney Care Centre, East Kent Hospitals University NHS (National Health Service) Foundation Trust for their cooperation and help. The study received statistical advice at the proposal stage from Drs A. Laurence and E. Bassett of the Institute of Mathematics, Statistics and Actuarial Science, University of Kent, Canterbury, Kent. Mr Paul Bassett, Statsconsultancy Ltd, Amersham, Buckinghamshire, UK, helped with data analysis.
Support: The
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Originally published online August 13, 2012.