Is the new mayo clinic quadratic equation useful for the estimation of glomerular filtration rate in type 2 diabetic patients?

Abstract

OBJECTIVE- To test the Mayo Clinic Quadratic (CQ) equation against isotopic glomerular filtration rate, compared with the Modification of Diet in Renal Disease (MDRD) and the Cockcroft-Gault formulas, in type 2 diabetes. RESEARCH DESIGN AND METHODS- Based on values obtained with iothalamate, 118 type 2 diabetic patients were divided into three groups according to renal function: hyper-filtration (26), normal function (56), or chronic kidney disease (CKD) stages 3-4 (36). ANOVA, the Bland-Altman procedure, and Lins coefficient (Rc) were performed to study accuracy. RESULTS- In the hyperfiltration and normal function groups, all prediction equations significantly underestimated the value obtained with isotopic glomerular filtration rate (P < 0.05). In the CKD group, all equations also presented significant differences with the isotopic method. However, MDRD had a bias of -5.3 (Rc 0.452), Cockcroft-Gault formula -0.2 (Rc 0.471), and the MCQ-4.5 (Rc 0.526). CONCLUSIONS- The MCQ and prediction equations proved inaccurate (excessive underestimation) in type 2 diabetic patients with hyperfiltration or normal renal function. With regard to CKD, the results obtained provided no evidence of superiority of the MCQ over the MDRD or the Cockcroft-Gault formula. © 2008 by the American Diabetes Association.