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Published ahead of print on January 19, 2005
J Am Soc Nephrol 16: 763-773, 2005
© 2005 American Society of Nephrology
doi: 10.1681/ASN.2004070549
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Chronic Kidney Disease

Predictive Performance of the Modification of Diet in Renal Disease and Cockcroft-Gault Equations for Estimating Renal Function

Marc Froissart*,{dagger},§, Jerome Rossert{dagger},||, Christian Jacquot{ddagger},§, Michel Paillard*,{dagger},§ and Pascal Houillier*,{dagger},§

* Department of Physiology and Biophysics, Georges Pompidou Hospital (AP-HP); {dagger} INSERM U652 and IFR 58; {ddagger} Department of Nephrology, Georges Pompidou Hospital (AP-HP); § René Descartes Medical School, Paris V University; and || Paris VI University, Paris, France

Address correspondence to: Dr. Marc Froissart, Department of Physiology and Biophysics, Georges Pompidou European Hospital, 20 rue Leblanc, 75015 Paris, France. Phone: +33-1-5609-3973; Fax: +33-1-5609-2675; E-mail: marc.froissart{at}egp.aphp.fr

Recent recommendations emphasize the need to assess kidney function using creatinine-based predictive equations to optimize the care of patients with chronic kidney disease. The most widely used equations are the Cockcroft-Gault (CG) and the simplified Modification of Diet in Renal Disease (MDRD) formulas. However, they still need to be validated in large samples of subjects, including large non-U.S. cohorts. Renal clearance of 51Cr-EDTA was compared with GFR estimated using either the CG equation or the MDRD formula in a cohort of 2095 adult Europeans (863 female and 1232 male; median age, 53.2 yr; median measured GFR, 59.8 ml/min per 1.73 m2). When the entire study population was considered, the CG and MDRD equations showed very limited bias. They overestimated measured GFR by 1.94 ml/min per 1.73 m2 and underestimated it by 0.99 ml/min per 1.73 m2, respectively. However, analysis of subgroups defined by age, gender, body mass index, and GFR level showed that the biases of the two formulas could be much larger in selected populations. Furthermore, analysis of the SD of the mean difference between estimated and measured GFR showed that both formulas lacked precision; the CG formula was less precise than the MDRD one in most cases. In the whole study population, the SD was 15.1 and 13.5 ml/min per 1.73 m2 for the CG and MDRD formulas, respectively. Finally, 29.2 and 32.4% of subjects were misclassified when the CG and MDRD formulas were used to categorize subjects according to the Kidney Disease Outcomes Quality Initiative chronic kidney disease classification, respectively.




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Ann Intern Med, January 2, 2007; 146(1): 74 - 74.
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 J. Am. Soc. Nephrol.Home page
S. Jacob, M. Hery, J.-C. Protois, J. Rossert, and B. Stengel
Effect of Organic Solvent Exposure on Chronic Kidney Disease Progression: The GN-PROGRESS Cohort Study
J. Am. Soc. Nephrol., January 1, 2007; 18(1): 274 - 281.
[Abstract] [Full Text] [PDF]

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 Nephrol Dial TransplantHome page
J. H. Macdonald, S. M. Marcora, M. Jibani, G. Roberts, M. J. Kumwenda, R. Glover, J. Barron, and A. B. Lemmey
Bioelectrical impedance can be used to predict muscle mass and hence improve estimation of glomerular filtration rate in non-diabetic patients with chronic kidney disease
Nephrol. Dial. Transplant., December 1, 2006; 21(12): 3481 - 3487.
[Abstract] [Full Text] [PDF]

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P. Gomez, L. M. Ruilope, V. Barrios, J. Navarro, M. A. Prieto, O. Gonzalez, L. Guerrero, M. A. S. Zamorano, C. Filozof, and on behalf of the FATH Study Group
Prevalence of Renal Insufficiency in Individuals with Hypertension and Obesity/Overweight: The FATH Study
J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S194 - S200.
[Abstract] [Full Text] [PDF]

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X. Wang, J. Lewis, L. Appel, D. Cheek, G. Contreras, M. Faulkner, H. Feldman, J. Gassman, J. Lea, J. Kopple, et al.
Validation of Creatinine-Based Estimates of GFR When Evaluating Risk Factors in Longitudinal Studies of Kidney Disease
J. Am. Soc. Nephrol., October 1, 2006; 17(10): 2900 - 2909.
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 CirculationHome page
J. A. Leopold
Small-Molecule Glycoprotein IIb/IIIa Antagonists and Bleeding Risk in Women: Too Much of a Good Thing?
Circulation, September 26, 2006; 114(13): 1344 - 1346.
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P. E. de Jong, N. Halbesma, and R. T. Gansevoort
Screening for early chronic kidney disease--what method fits best?
Nephrol. Dial. Transplant., September 1, 2006; 21(9): 2358 - 2361.
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B. B. Newsome, W. M. McClellan, C. S. Coffey, J. J. Allison, C. I. Kiefe, and D. G. Warnock
Survival Advantage of Black Patients with Kidney Disease after Acute Myocardial Infarction
Clin. J. Am. Soc. Nephrol., September 1, 2006; 1(5): 993 - 999.
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A. S. Levey, J. Coresh, T. Greene, L. A. Stevens, Y. Zhang, S. Hendriksen, J. W. Kusek, F. Van Lente, and for the Chronic Kidney Disease Epidemiology Collab
Using Standardized Serum Creatinine Values in the Modification of Diet in Renal Disease Study Equation for Estimating Glomerular Filtration Rate
Ann Intern Med, August 15, 2006; 145(4): 247 - 254.
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P. Rodrigo and M. R. Andres
Cockroft-Gault or abbreviated-MDRD equations--which 'weighs' more in cardiovascular risk?
Nephrol. Dial. Transplant., August 1, 2006; 21(8): 2342 - 2343.
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