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Erschienen in: European Radiology 10/2011

01.10.2011 | Physics

Significant differences when using MDRD for GFR estimation compared to radionuclide measured clearance

verfasst von: A. J. Craig, A. Britten, S. D. Heenan, A. G. Irwin

Erschienen in: European Radiology | Ausgabe 10/2011

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Abstract

Objectives

To evaluate Estimated Glomerular Filtration Rate (eGFR), using the Modification of Diet in Renal Disease equation, and compare with radionuclide GFR (rGFR) in a Radiology setting to assess renal function prior to contrast administration.

Methods

Five hundred and sixteen retrospective rGFR studies from a mixed referral population were selected and the eGFR calculated. Regression and Bland-Altman analysis was performed. The percentage of rGFR and eGFR studies below 30 ml/min/1.73 m2 and 60 ml/min/1.73 m2 were calculated; these are important thresholds for classifying renal insufficiency.

Results

A significant correlation between eGFR and rGFR (R2 = 0.62, p < 0.0001) and significant differences in the medians (p < 0.0001) were found. eGFR overestimated rGFR with a bias (mean difference) of 10.8 ml/min/1.73 m2 over the whole range of rGFR. Studies with an rGFR of under 30 ml/min/1.73 m2 had a mean bias of 4.6 ml/min/1.73 m2 (difference range −5.9 to 26.3 ml/min/1.73 m2). The bias over the range 30 to 60 ml/min/1.73 m2 was 13.2 ml/min/1.73 m2 (difference range −16.8 to 88.3 ml/min/1.73 m2). In 25.4% of studies, eGFR was less than 60 ml/min/1.73 m2 compared with 40.5% of rGFR studies.

Conclusions

Awareness of the bias between eGFR and rGFR is important when assessing Radiology patients for risks of nephrotoxicity and Nephrogenic Systemic Fibrosis from contrast medium.
Literatur
1.
Zurück zum Zitat Thomsen HS (2006) Nephrogenic systemic fibrosis: a serious late adverse reaction to gadiodiamide. Eur Radiol 16:2619–2621PubMedCrossRef Thomsen HS (2006) Nephrogenic systemic fibrosis: a serious late adverse reaction to gadiodiamide. Eur Radiol 16:2619–2621PubMedCrossRef
2.
Zurück zum Zitat Rydahl C, Thomsen H, Marckmann P (2008) High prevalence of Nephrogenic systemic fibrosis in chronic renal failure patients exposed to gadodiamide, a gadolinium-containing magnetic resonance contrast agent. Invest Radiol 43:141–144PubMedCrossRef Rydahl C, Thomsen H, Marckmann P (2008) High prevalence of Nephrogenic systemic fibrosis in chronic renal failure patients exposed to gadodiamide, a gadolinium-containing magnetic resonance contrast agent. Invest Radiol 43:141–144PubMedCrossRef
3.
Zurück zum Zitat Perez-Rodriguez J, Lai S, Ehst BD, Fine DM, Bluemke DA (2009) Nephrogenic systemic fibrosis: incidence, associations, and effect of risk factor assessment-report of 33 cases. Radiology 250:371–377PubMedCrossRef Perez-Rodriguez J, Lai S, Ehst BD, Fine DM, Bluemke DA (2009) Nephrogenic systemic fibrosis: incidence, associations, and effect of risk factor assessment-report of 33 cases. Radiology 250:371–377PubMedCrossRef
4.
Zurück zum Zitat Sadowski E, Bennett LK, Chan MR et al (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 243:148–157PubMedCrossRef Sadowski E, Bennett LK, Chan MR et al (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 243:148–157PubMedCrossRef
5.
Zurück zum Zitat Chewning RH, Murphy KJ (2007) Gadolinium-based contrast media and the development of nephrogenic systemic fibrosis in patients with renal insufficiency. J Vasc Interv Radiol 18:331–334PubMedCrossRef Chewning RH, Murphy KJ (2007) Gadolinium-based contrast media and the development of nephrogenic systemic fibrosis in patients with renal insufficiency. J Vasc Interv Radiol 18:331–334PubMedCrossRef
6.
Zurück zum Zitat Joffe P, Thomsen HS, Meusel M (1998) Pharmokinetics of gadiodiamide injection in patients with severe renal insufficiency and patients under going hemodialysis or continuous ambulatory peritoneal dialysis. Acad Radiol 5:491–502PubMedCrossRef Joffe P, Thomsen HS, Meusel M (1998) Pharmokinetics of gadiodiamide injection in patients with severe renal insufficiency and patients under going hemodialysis or continuous ambulatory peritoneal dialysis. Acad Radiol 5:491–502PubMedCrossRef
7.
Zurück zum Zitat Leiner T, Herborn CU, Goyen M (2007) Nephrogenic systemic fibrosis is not exclusively associated with Gadodiamide. Eur Radiol 17:1921–1923PubMedCrossRef Leiner T, Herborn CU, Goyen M (2007) Nephrogenic systemic fibrosis is not exclusively associated with Gadodiamide. Eur Radiol 17:1921–1923PubMedCrossRef
8.
Zurück zum Zitat Thomsen HS, European Society of Urogenital Radiology (ESUR) (2007) ESUR guideline: gadolinium-based contrast media and nephrogenic systemic fibrosis. Eur Radiol 17:2692–2696PubMedCrossRef Thomsen HS, European Society of Urogenital Radiology (ESUR) (2007) ESUR guideline: gadolinium-based contrast media and nephrogenic systemic fibrosis. Eur Radiol 17:2692–2696PubMedCrossRef
11.
Zurück zum Zitat National Kidney Foundation (2002) KDOQI clinical practise guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis Suppl 39:1–266 National Kidney Foundation (2002) KDOQI clinical practise guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis Suppl 39:1–266
12.
Zurück zum Zitat Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med 130:461–470PubMed Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med 130:461–470PubMed
13.
Zurück zum Zitat Levey AS, Greene T, Kusek JW, Beck GJ (2000) A simplified equation to predict glomerular filtration rate from serum creatinine. J Am Soc Nephrol 11:155A Levey AS, Greene T, Kusek JW, Beck GJ (2000) A simplified equation to predict glomerular filtration rate from serum creatinine. J Am Soc Nephrol 11:155A
14.
Zurück zum Zitat Levey AS, Coresh J, Greene T et al (2005) Expressing the MDRD study equation for estimating GFR with IDMS traceable (gold standard) serum creatinine values. J Am Soc Nephrol 16:69A Levey AS, Coresh J, Greene T et al (2005) Expressing the MDRD study equation for estimating GFR with IDMS traceable (gold standard) serum creatinine values. J Am Soc Nephrol 16:69A
15.
Zurück zum Zitat Levey AS, Coresh J, Greene T et al (2006) Using standardised serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145:247–254PubMed Levey AS, Coresh J, Greene T et al (2006) Using standardised serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145:247–254PubMed
17.
Zurück zum Zitat Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41PubMedCrossRef Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41PubMedCrossRef
18.
Zurück zum Zitat Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J (2009) CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612PubMed Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J (2009) CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612PubMed
19.
Zurück zum Zitat Zahran A, El-Husseini A, Shoker A (2007) Can Cystatin C replace creatinine to estimate glomerular filtration rate? Literature review. Am J Nephrol 27:197–205PubMedCrossRef Zahran A, El-Husseini A, Shoker A (2007) Can Cystatin C replace creatinine to estimate glomerular filtration rate? Literature review. Am J Nephrol 27:197–205PubMedCrossRef
20.
Zurück zum Zitat Lu C-F, Hsiao C-H, Tiju J-W (2009) Nephrogenic systemic fibrosis developed after recovery from acute renal failure: gadolinium as a possible aetiological factor. J Eur Acad Dermatol Venereol 23:339–340PubMedCrossRef Lu C-F, Hsiao C-H, Tiju J-W (2009) Nephrogenic systemic fibrosis developed after recovery from acute renal failure: gadolinium as a possible aetiological factor. J Eur Acad Dermatol Venereol 23:339–340PubMedCrossRef
21.
Zurück zum Zitat Herts BR, Schneider E, Obuchowski NA, Poggio ED, Jain A, Baker ME (2009) Probability of reduced renal function after contrast-enhanced CT: a model based on serum creatinine level, patient age, and estimated glomerular filtration rate. Am J Roentgenol 193:494–500CrossRef Herts BR, Schneider E, Obuchowski NA, Poggio ED, Jain A, Baker ME (2009) Probability of reduced renal function after contrast-enhanced CT: a model based on serum creatinine level, patient age, and estimated glomerular filtration rate. Am J Roentgenol 193:494–500CrossRef
22.
Zurück zum Zitat Ledermann HP, Mengiardi B, Schmid A, Froehlich JM (2010) Screening for renal insufficiency following ESUR (European Society of Urogenital Radiology) guidelines with on-site creatinine measurements in an outpatient setting. Eur Radiol 20:1926–1933PubMedCrossRef Ledermann HP, Mengiardi B, Schmid A, Froehlich JM (2010) Screening for renal insufficiency following ESUR (European Society of Urogenital Radiology) guidelines with on-site creatinine measurements in an outpatient setting. Eur Radiol 20:1926–1933PubMedCrossRef
23.
Zurück zum Zitat Herts BR, Schneider E, Poggio ED, Obuchowski NA, Baker ME (2008) Identifying outpatients with renal insufficiency before contrast-enhanced CT by using estimated glomerular filtration rates versus serum creatinine levels. Radiology 248:106–113PubMedCrossRef Herts BR, Schneider E, Poggio ED, Obuchowski NA, Baker ME (2008) Identifying outpatients with renal insufficiency before contrast-enhanced CT by using estimated glomerular filtration rates versus serum creatinine levels. Radiology 248:106–113PubMedCrossRef
25.
Zurück zum Zitat Bird NJ, Peters C, Michell AR, Peters AM (2008) Reliability of the MDRD method for estimating glomerular filtration rate in relation to gender, body mass index and extracellular fluid volume. Eur J Clin Invest 38:486–493PubMedCrossRef Bird NJ, Peters C, Michell AR, Peters AM (2008) Reliability of the MDRD method for estimating glomerular filtration rate in relation to gender, body mass index and extracellular fluid volume. Eur J Clin Invest 38:486–493PubMedCrossRef
26.
Zurück zum Zitat Froissart M, Rossert J, Jacquot C, Paillard M, Houillier P (2005) Predictive performance of the modification of diet in renal disease and Cockcroft-Gault equations for estimating renal function. J Am Soc Nephrol 16:763–773PubMedCrossRef Froissart M, Rossert J, Jacquot C, Paillard M, Houillier P (2005) Predictive performance of the modification of diet in renal disease and Cockcroft-Gault equations for estimating renal function. J Am Soc Nephrol 16:763–773PubMedCrossRef
27.
Zurück zum Zitat Beauvieux MC, Le Moigne F, Lasseur C, Raffaitin C, Perlemoine C, Barthe N, Chauveau P, Combe C, Gin H, Rigalleau V (2007) New predictive equations improve monitoring of kidney function in patients with diabetes. Diabetes Care 30:1988–1994PubMedCrossRef Beauvieux MC, Le Moigne F, Lasseur C, Raffaitin C, Perlemoine C, Barthe N, Chauveau P, Combe C, Gin H, Rigalleau V (2007) New predictive equations improve monitoring of kidney function in patients with diabetes. Diabetes Care 30:1988–1994PubMedCrossRef
28.
Zurück zum Zitat Rigalleau V, Lasseur C, Perlemoine C, Barthe N, Raffaitin C, Liu C, Chauveau P, Baillet-Blanco L, Combe C, Gin H (2005) Estimation of glomerular filtration rate in diabetic subjects: Cockcroft formula or modification of diet in renal disease study equation? Diabetes Care 28:838–843PubMedCrossRef Rigalleau V, Lasseur C, Perlemoine C, Barthe N, Raffaitin C, Liu C, Chauveau P, Baillet-Blanco L, Combe C, Gin H (2005) Estimation of glomerular filtration rate in diabetic subjects: Cockcroft formula or modification of diet in renal disease study equation? Diabetes Care 28:838–843PubMedCrossRef
29.
Zurück zum Zitat Lamb EJ, Webb MC, Simpson DE, Coakley AJ, Newman DJ, O’Riordan SE (2003) Estimation of glomerular filtration rate in older patients with chronic renal insufficiency: Is the modification of diet in renal disease an improvement? J Am Geriatr Soc 51:1012–1017PubMedCrossRef Lamb EJ, Webb MC, Simpson DE, Coakley AJ, Newman DJ, O’Riordan SE (2003) Estimation of glomerular filtration rate in older patients with chronic renal insufficiency: Is the modification of diet in renal disease an improvement? J Am Geriatr Soc 51:1012–1017PubMedCrossRef
30.
Zurück zum Zitat Aydn F, Gungor F, Kin Cengiz A, Tuncer M, Mahsereci E, Ozdem S, Cenkci M, Karayalcin B (2008) Comparison of glomerular filtration rate measurements with the two plasma sample and single plasma sample, gamma camera Gates, creatinine clearance, and prediction equation methods in potential kidney donors with normal renal function. Nucl Med Commun 29:157–165CrossRef Aydn F, Gungor F, Kin Cengiz A, Tuncer M, Mahsereci E, Ozdem S, Cenkci M, Karayalcin B (2008) Comparison of glomerular filtration rate measurements with the two plasma sample and single plasma sample, gamma camera Gates, creatinine clearance, and prediction equation methods in potential kidney donors with normal renal function. Nucl Med Commun 29:157–165CrossRef
31.
Zurück zum Zitat Lin J, Knight EL, Hogan ML, Singh AK (2003) A comparison of predictive equations for estimating glomerular filtration rate in adults without kidney disease. J Am Soc Nephrol 14:2573–2580PubMedCrossRef Lin J, Knight EL, Hogan ML, Singh AK (2003) A comparison of predictive equations for estimating glomerular filtration rate in adults without kidney disease. J Am Soc Nephrol 14:2573–2580PubMedCrossRef
32.
Zurück zum Zitat Saleem M, Florkowski CM, George PM, Wolersdorf WWW (2006) Comparison of two prediction equations with radionuclide glomerular filtration rate: validation in routine use. Ann Clin Biochem 43:309–313PubMedCrossRef Saleem M, Florkowski CM, George PM, Wolersdorf WWW (2006) Comparison of two prediction equations with radionuclide glomerular filtration rate: validation in routine use. Ann Clin Biochem 43:309–313PubMedCrossRef
33.
Zurück zum Zitat Poggio ED, Wang X, Weinstein DM et al (2006) Assessing glomerular filtration rate by estimation equations in kidney transplant recipients. Am J Transplant 6:100–108PubMedCrossRef Poggio ED, Wang X, Weinstein DM et al (2006) Assessing glomerular filtration rate by estimation equations in kidney transplant recipients. Am J Transplant 6:100–108PubMedCrossRef
34.
Zurück zum Zitat Poggio ED, Wang X, Greene T, Van Lente F, Hall PM (2005) Performance of the modification of diet in renal disease and Cockcroft-Gault equations in the estimation of GFR in health and in chronic kidney disease. J Am Soc Nephrol 16:459–466PubMedCrossRef Poggio ED, Wang X, Greene T, Van Lente F, Hall PM (2005) Performance of the modification of diet in renal disease and Cockcroft-Gault equations in the estimation of GFR in health and in chronic kidney disease. J Am Soc Nephrol 16:459–466PubMedCrossRef
35.
Zurück zum Zitat Lipscey M, Furebring M, Rubertsson S, Larsson A (2011) Significant differences when using creatinine, modification of diet in renal disease, or cystatin C for estimating glomerular filtration rate in ICU patients. Ups J Med Sci 116:39–46CrossRef Lipscey M, Furebring M, Rubertsson S, Larsson A (2011) Significant differences when using creatinine, modification of diet in renal disease, or cystatin C for estimating glomerular filtration rate in ICU patients. Ups J Med Sci 116:39–46CrossRef
37.
Zurück zum Zitat Chantler C, Garnett ES, Parsons V, Veall N (1969) Glomerular filtration rate measurement in man by the single injection method using 51Cr-EDTA. Clin Sci 37:169–180PubMed Chantler C, Garnett ES, Parsons V, Veall N (1969) Glomerular filtration rate measurement in man by the single injection method using 51Cr-EDTA. Clin Sci 37:169–180PubMed
38.
Zurück zum Zitat Brochner-Mortensen J (1972) A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 30:271–274PubMedCrossRef Brochner-Mortensen J (1972) A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 30:271–274PubMedCrossRef
39.
Zurück zum Zitat Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327:307–310CrossRef Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327:307–310CrossRef
41.
Zurück zum Zitat Erselcan T, Hasbek Z, Tandogan I, Gumus C, Akkurt I (2009) Modification of diet in renal disease equation in the risk stratification of contrast induced acute kidney injury in hospital inpatients. Nefrologia 29:397–403PubMed Erselcan T, Hasbek Z, Tandogan I, Gumus C, Akkurt I (2009) Modification of diet in renal disease equation in the risk stratification of contrast induced acute kidney injury in hospital inpatients. Nefrologia 29:397–403PubMed
42.
Zurück zum Zitat Van Deventer HE, George JA, Paiker JE, Becker PJ, Katz IJ (2008) Estimating glomerular filtration rate in black South Africans by use of the modification of diet in renal disease and Cockcroft-Gault equations. Clin Chem 54:1197–1202PubMedCrossRef Van Deventer HE, George JA, Paiker JE, Becker PJ, Katz IJ (2008) Estimating glomerular filtration rate in black South Africans by use of the modification of diet in renal disease and Cockcroft-Gault equations. Clin Chem 54:1197–1202PubMedCrossRef
43.
Zurück zum Zitat Mahajan S, Mukhiya GK, Singh R et al (2005) Assessing suitability for renal donation: can equations predicting glomerular filtration rate substitute for a reference method in the Indian population? Nephron 101:c128–c133PubMed Mahajan S, Mukhiya GK, Singh R et al (2005) Assessing suitability for renal donation: can equations predicting glomerular filtration rate substitute for a reference method in the Indian population? Nephron 101:c128–c133PubMed
44.
Zurück zum Zitat Al-Khader AA, Tamim H, Al Sulaiman MH et al (2008) What is the most appropriate formula to use in estimating glomerular filtration rate in adult Arabs without kidney disease? Ren Fail 30:205–208PubMedCrossRef Al-Khader AA, Tamim H, Al Sulaiman MH et al (2008) What is the most appropriate formula to use in estimating glomerular filtration rate in adult Arabs without kidney disease? Ren Fail 30:205–208PubMedCrossRef
Metadaten
Titel
Significant differences when using MDRD for GFR estimation compared to radionuclide measured clearance
verfasst von
A. J. Craig
A. Britten
S. D. Heenan
A. G. Irwin
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 10/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2157-8

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