open access

Vol 13, No 2 (2009)
Prace oryginalne
Published online: 2009-03-10
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Modification of diet in renal disease (MDRD) and Cockcroft-Gault equations in estimation of glomerular filtration rate in patients with coronary artery disease and hypertension

Marek Klocek, Aleksander Mazur, Jowita Chmielewska, Grzegorz Bilo, Anna Stochmal, Jerzy W. Naskalski, Kalina Kawecka-Jaszcz
Nadciśnienie tętnicze 2009;13(2):97-105.

open access

Vol 13, No 2 (2009)
Prace oryginalne
Published online: 2009-03-10

Abstract


Background Gromelural filtration rate (GFR) provides the most accurate estimation of renal function. Reliable GRF estimation is critical to diagnosis of chronic kidney disease. The aim of the study was to evaluate the Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations for their accuracy in determining GFR in hypertensive patients with coronary artery disease (CAD) and to assess a frequency and factors determining renal impairment in this group of patients.
Material and methods We recruited 299 consecutive patients (191 men and 108 women) admitted to hospital, aged 63.6 ± 11.3 years with 1-3 stage arterial hypertension acc. to ESH/ESC (duration 10.8 ± 8.7 years) and CAD (6.8 ± 3.2 years). Among them 89 (29.8%) pts had type 2 diabetes. There were 99 (33.1%) patients in I CCS class, 160 (53.5%) - in II, and 40 (13.4%) in III-IV CCS class. In 145 patients (48.5%) coronary arteriograhy had been performed during hospitalzation. In all patients eGFR estimation was done before any procedures by CG formula, as well as by the MDRD abbreviated equation. Then MDRD equation was compared with the CG formula to detect patients with renal impairment (GFR < 60 ml/min/1.73 m2). Results The mean CG and MDRD estimated GFR were 83.5 ± 30.4 ml/min/1.73 m2 and 76.7 ± 23.4 ml/min/1.73 m2, respectively. Moderate renal impairment (< 60 ml/ /min/1.73 m2) was observed in 92 pts by CG formula vs. 110 pts by MDRD one (p < 0.05). Acc. to CG 3.7% patients had severe renal impairment (< 30 ml/min/1.73 m2) versus 9.0% with the MDRD equation (p < 0.01). Negative correlations (p < 0.05) between eGFR, both MDRD (r = -0.61) and CG (r = -0.52), and CCS class of CAD, as well as age (r = -0.68 and r = -0.65, respectively) were found in both sexes. In study group, the MDRD thresholds that would correspond to CG values of 30 ml/min and 60 ml/min were found lower: 8 ml/min/1.73 m2 and 6 ml/ /min/1.73 m2, respectively. In 145 subjects who underwent coronarography lowest eGFR was found in those with three-vessel CAD.
Conclusions In hypertensive patients with CAD, eGFR values derived from MDRD equations identifies significantly higher numbers of individuals with chronic kidney disease then assessed by CG formula. The frequency of renal impairment arises with age and longevity of hypertension and CAD, as well as type 2 diabetes.

Abstract


Background Gromelural filtration rate (GFR) provides the most accurate estimation of renal function. Reliable GRF estimation is critical to diagnosis of chronic kidney disease. The aim of the study was to evaluate the Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations for their accuracy in determining GFR in hypertensive patients with coronary artery disease (CAD) and to assess a frequency and factors determining renal impairment in this group of patients.
Material and methods We recruited 299 consecutive patients (191 men and 108 women) admitted to hospital, aged 63.6 ± 11.3 years with 1-3 stage arterial hypertension acc. to ESH/ESC (duration 10.8 ± 8.7 years) and CAD (6.8 ± 3.2 years). Among them 89 (29.8%) pts had type 2 diabetes. There were 99 (33.1%) patients in I CCS class, 160 (53.5%) - in II, and 40 (13.4%) in III-IV CCS class. In 145 patients (48.5%) coronary arteriograhy had been performed during hospitalzation. In all patients eGFR estimation was done before any procedures by CG formula, as well as by the MDRD abbreviated equation. Then MDRD equation was compared with the CG formula to detect patients with renal impairment (GFR < 60 ml/min/1.73 m2). Results The mean CG and MDRD estimated GFR were 83.5 ± 30.4 ml/min/1.73 m2 and 76.7 ± 23.4 ml/min/1.73 m2, respectively. Moderate renal impairment (< 60 ml/ /min/1.73 m2) was observed in 92 pts by CG formula vs. 110 pts by MDRD one (p < 0.05). Acc. to CG 3.7% patients had severe renal impairment (< 30 ml/min/1.73 m2) versus 9.0% with the MDRD equation (p < 0.01). Negative correlations (p < 0.05) between eGFR, both MDRD (r = -0.61) and CG (r = -0.52), and CCS class of CAD, as well as age (r = -0.68 and r = -0.65, respectively) were found in both sexes. In study group, the MDRD thresholds that would correspond to CG values of 30 ml/min and 60 ml/min were found lower: 8 ml/min/1.73 m2 and 6 ml/ /min/1.73 m2, respectively. In 145 subjects who underwent coronarography lowest eGFR was found in those with three-vessel CAD.
Conclusions In hypertensive patients with CAD, eGFR values derived from MDRD equations identifies significantly higher numbers of individuals with chronic kidney disease then assessed by CG formula. The frequency of renal impairment arises with age and longevity of hypertension and CAD, as well as type 2 diabetes.
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Keywords

hypertension; coronary artery disease; glomerular filtration rate; MDRD formula; Cockcroft-Gault formula

About this article
Title

Modification of diet in renal disease (MDRD) and Cockcroft-Gault equations in estimation of glomerular filtration rate in patients with coronary artery disease and hypertension

Journal

Arterial Hypertension

Issue

Vol 13, No 2 (2009)

Pages

97-105

Published online

2009-03-10

Bibliographic record

Nadciśnienie tętnicze 2009;13(2):97-105.

Keywords

hypertension
coronary artery disease
glomerular filtration rate
MDRD formula
Cockcroft-Gault formula

Authors

Marek Klocek
Aleksander Mazur
Jowita Chmielewska
Grzegorz Bilo
Anna Stochmal
Jerzy W. Naskalski
Kalina Kawecka-Jaszcz

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