Superiority of the Modification of Diet in Renal Disease equation over the Cockcroft–Gault equation in screening for impaired kidney function in Japanese Americans
The Cockcroft–Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24-h urinary creatinine clearance, the latter as a standard measurement of glomerular filtratio...
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| Published in | Diabetes research and clinical practice Vol. 77; no. 2; pp. 320 - 326 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Ireland
Elsevier Ireland Ltd
01.08.2007
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0168-8227 1872-8227 |
| DOI | 10.1016/j.diabres.2006.11.001 |
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| Abstract | The Cockcroft–Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24-h urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1
±
5.8 years, mean
±
S.D.) who had normal glucose tolerance (NGT) (
n
=
138), impaired glucose tolerance (IGT) (
n
=
136) and diabetes (
n
=
124). Although both the Cockcroft–Gault (
r
=
0.65,
P
<
0.001) and the MDRD (
r
=
0.74,
P
<
0.001) equations correlated well with creatinine clearance, the latter was significantly superior (
P
=
0.013 between
r values). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft–Gault equation (AUC 0.86 versus 0.80,
P
=
0.015) in classifying subjects as having mildly reduced GFR (<90
ml/min per 1.73
m
2). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD. |
|---|---|
| AbstractList | The Cockcroft–Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24-h urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1
±
5.8 years, mean
±
S.D.) who had normal glucose tolerance (NGT) (
n
=
138), impaired glucose tolerance (IGT) (
n
=
136) and diabetes (
n
=
124). Although both the Cockcroft–Gault (
r
=
0.65,
P
<
0.001) and the MDRD (
r
=
0.74,
P
<
0.001) equations correlated well with creatinine clearance, the latter was significantly superior (
P
=
0.013 between
r values). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft–Gault equation (AUC 0.86 versus 0.80,
P
=
0.015) in classifying subjects as having mildly reduced GFR (<90
ml/min per 1.73
m
2). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD. The Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24-h urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1+/-5.8 years, mean+/-S.D.) who had normal glucose tolerance (NGT) (n=138), impaired glucose tolerance (IGT) (n=136) and diabetes (n=124). Although both the Cockcroft-Gault (r=0.65, P<0.001) and the MDRD (r=0.74, P<0.001) equations correlated well with creatinine clearance, the latter was significantly superior (P=0.013 between r values). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft-Gault equation (AUC 0.86 versus 0.80, P=0.015) in classifying subjects as having mildly reduced GFR (<90ml/min per 1.73m(2)). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD.The Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24-h urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1+/-5.8 years, mean+/-S.D.) who had normal glucose tolerance (NGT) (n=138), impaired glucose tolerance (IGT) (n=136) and diabetes (n=124). Although both the Cockcroft-Gault (r=0.65, P<0.001) and the MDRD (r=0.74, P<0.001) equations correlated well with creatinine clearance, the latter was significantly superior (P=0.013 between r values). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft-Gault equation (AUC 0.86 versus 0.80, P=0.015) in classifying subjects as having mildly reduced GFR (<90ml/min per 1.73m(2)). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD. The Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24-h urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1+/-5.8 years, mean+/-S.D.) who had normal glucose tolerance (NGT) (n=138), impaired glucose tolerance (IGT) (n=136) and diabetes (n=124). Although both the Cockcroft-Gault (r=0.65, P<0.001) and the MDRD (r=0.74, P<0.001) equations correlated well with creatinine clearance, the latter was significantly superior (P=0.013 between r values). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft-Gault equation (AUC 0.86 versus 0.80, P=0.015) in classifying subjects as having mildly reduced GFR (<90ml/min per 1.73m(2)). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD. Abstract The Cockcroft–Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24-h urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1 ± 5.8 years, mean ± S.D.) who had normal glucose tolerance (NGT) ( n = 138), impaired glucose tolerance (IGT) ( n = 136) and diabetes ( n = 124). Although both the Cockcroft–Gault ( r = 0.65, P < 0.001) and the MDRD ( r = 0.74, P < 0.001) equations correlated well with creatinine clearance, the latter was significantly superior ( P = 0.013 between r values). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft–Gault equation (AUC 0.86 versus 0.80, P = 0.015) in classifying subjects as having mildly reduced GFR (<90 ml/min per 1.73 m2 ). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD. The Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24 hour urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1±5.8y, mean±SD) who had normal glucose tolerance (n=138), impaired glucose tolerance (n=136) and diabetes (n=124). Although both the Cockcroft-Gault (r=0.65, P<0.001) and the MDRD (r=0.74, P<0.001) equations correlated well with creatinine clearance, the latter was significantly superior (P=0.013 between r values). ROC curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft-Gault equation (AUC 0.86 vs. 0.80, P=0.015) in classifying subjects as having mildly reduced GFR (<90 ml/min per 1.73 m 2 ). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD. |
| Author | Udayasankar, Jayalakshmi Gerchman, Fernando Utzschneider, Kristina M. Zraika, Sakeneh Boyko, Edward J. Tong, Jenny McNeely, Marguerite J. Kahn, Steven E. Andress, Dennis L. Fujimoto, Wilfred Y. Hull, Rebecca L. Leonetti, Donna L. |
| AuthorAffiliation | 2 Division of General Internal Medicine, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA 3 Division of Nephrology, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA 4 Department of Anthropology, University of Washington, Seattle, WA 1 Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA 5 Epidemiology Research Information Center, VA Puget Sound Health Care System, Seattle WA |
| AuthorAffiliation_xml | – name: 2 Division of General Internal Medicine, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA – name: 3 Division of Nephrology, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA – name: 5 Epidemiology Research Information Center, VA Puget Sound Health Care System, Seattle WA – name: 1 Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA – name: 4 Department of Anthropology, University of Washington, Seattle, WA |
| Author_xml | – sequence: 1 givenname: Fernando surname: Gerchman fullname: Gerchman, Fernando organization: Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 2 givenname: Jenny surname: Tong fullname: Tong, Jenny organization: Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 3 givenname: Kristina M. surname: Utzschneider fullname: Utzschneider, Kristina M. organization: Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 4 givenname: Rebecca L. surname: Hull fullname: Hull, Rebecca L. organization: Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 5 givenname: Sakeneh surname: Zraika fullname: Zraika, Sakeneh organization: Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 6 givenname: Jayalakshmi surname: Udayasankar fullname: Udayasankar, Jayalakshmi organization: Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 7 givenname: Marguerite J. surname: McNeely fullname: McNeely, Marguerite J. organization: Division of General Internal Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 8 givenname: Dennis L. surname: Andress fullname: Andress, Dennis L. organization: Division of Nephrology, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 9 givenname: Donna L. surname: Leonetti fullname: Leonetti, Donna L. organization: Department of Anthropology, University of Washington, Seattle, WA, USA – sequence: 10 givenname: Edward J. surname: Boyko fullname: Boyko, Edward J. organization: Division of General Internal Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 11 givenname: Wilfred Y. surname: Fujimoto fullname: Fujimoto, Wilfred Y. organization: Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA – sequence: 12 givenname: Steven E. surname: Kahn fullname: Kahn, Steven E. email: skahn@u.washington.edu organization: Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/17141914$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1002_dmrr_2793 crossref_primary_10_1080_17512433_2020_1798759 crossref_primary_10_1111_j_1748_7692_2007_00162_x crossref_primary_10_1681_ASN_2013050567 crossref_primary_10_1111_j_1445_5994_2010_02398_x crossref_primary_10_1053_j_jrn_2021_11_001 crossref_primary_10_1155_2014_521071 crossref_primary_10_1002_dmrr_822 crossref_primary_10_47102_annals_acadmedsg_V39N3p179 |
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| Keywords | Diabetes Creatinine clearance MDRD Cockcroft–Gault Glomerular filtration rate |
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| Snippet | The Cockcroft–Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of... Abstract The Cockcroft–Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying... The Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of... |
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| SubjectTerms | Aged Asian People Blood Pressure Body Mass Index Cockcroft–Gault Creatinine - blood Creatinine - urine Creatinine clearance Diabetes Diabetic Nephropathies - epidemiology Diabetic Nephropathies - physiopathology Endocrinology & Metabolism Female Glomerular Filtration Rate Glucose Intolerance - physiopathology Glucose Tolerance Test Humans Japan Kidney Diseases - diagnosis Kidney Diseases - diet therapy Kidney Diseases - physiopathology Male MDRD Middle Aged Risk Factors |
| Title | Superiority of the Modification of Diet in Renal Disease equation over the Cockcroft–Gault equation in screening for impaired kidney function in Japanese Americans |
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