A simplified Cockcroft-Gault formula to improve the prediction of the glomerular filtration rate in diabetic patients

Diabetes & Metabolism
V RigalleauH Gin

Abstract

The National Kidney Foundation recommends stratification of renal failure into moderate (Glomerular Filtration Rate: GFR = 30-60 mL/min/1.73 m2), severe (15-30) or terminal (<15) using the Cockcroft-Gault (CG) or the Modification of Diet in Renal Disease (MDRD) equations. We studied the biases in these methods in an attempt to improve the standard CG (MCG) and devise a strategy for stratification. GFR was measured by 51Cr-EDTA clearance in 200 diabetic patients: 100 (Group 1: study of concordance) before 2003 and 100 thereafter (Group 2: validation of MCG). The CG was modified by replacing body weight by its mean value: 76. In group 1, the recommended equations only correctly stratified 50 patients. The CG, not the MDRD, underestimated GFR if BMI was normal, and overestimated it in obese patients. In group 2, the MCG was well correlated with GFR and not biased by weight. Over the whole population, the MCG and MDRD were more accurate for the diagnosis of moderate and severe renal failure. The MDRD showed the lowest differences with GFR, except if GFR > 60, where the MCG performed better. All formulae overestimated low GFR, the MDRD also underestimated high GFR. The best stratification (147/200) was obtained using the MCG if crea...Continue Reading

References

Jan 1, 1976·Nephron·D W Cockcroft, M H Gault
Jan 1, 1992·Nephron·M H GaultC Wesolowski
Nov 16, 1999·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·E RitzS Halimi
Jul 12, 2002·Kidney International·Noël J M CanoUNKNOWN French Study Group for Nutrition in Dialysis (FSG-ND)
Oct 29, 2002·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Gerald VervoortJack F M Wetzels
Jul 16, 2003·Annals of Internal Medicine·Andrew S LeveyUNKNOWN National Kidney Foundation
Dec 25, 2003·Diabetes Care·Richard J MacIsaacGeorge Jerums
Jan 22, 2005·Journal of the American Society of Nephrology : JASN·Marc FroissartPascal Houillier

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Citations

Jun 18, 2011·Diabetes & Metabolism·V RigalleauH Gin
Mar 1, 2016·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Aki KozonoYoshiharu Karube
Jun 27, 2013·Orvosi hetilap·György GámánBalázs Nemes
May 16, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Sergio Luis-LimaEsteban Porrini
Dec 7, 2018·Nature Reviews. Nephrology·Esteban PorriniGiuseppe Remuzzi
Sep 29, 2019·Journal of Clinical Medicine·Sergio Luis-LimaEsteban Porrini

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