Comparison of various predictive equations for glomerular filtration rate in healthy individuals and chronic kidney disease patients from North India

Abstract

A noninvasive and accurate estimate of the glomerular filtration rate (GFR) is an essential prerequisite for medical professionals. In the absence of 24-h urinary creatinine clearance, various predictive equations can be utilized for estimating GFR. A cross-sectional observational study was conducted on healthy adults as well as adult chronic kidney disease (CKD) Indian population. In normal males and females, Modification of Diet in Renal Disease-4 (MDRD-4) and Cockcroft-Gault (CG) were the best equations respectively, which showed the best correlation and best precision in CKD stage 1 males and females, MDRD-4 and MDRD-6 were the best equations respectively In CKD stage 2 males and females, CKD-Epidemiology Collaboration (CKD-EPI) was adjudged the best equation, which showed the best correlation, best precision, and least bias. In CKD stage 3 males and females, CG and CKD-EPI were the best equation respectively, with the best correlation, best precision, least biased, and most accuracy. In CKD stage 4 males and females, MDRD-6 and MDRD-4 showed the best correlation, best precision and most accuracy respectively. In CKD stage 5, CKD-EPI demonstrated the best results in both sexes. We observed that all the predictive equations were good estimates of GFR in one or other stages of CKD, but no single predictive equation showed consistent results when compared among normal subjects and CKD sub-groups.