MDRD equation

Conventional calibration MDRD equation [used only with those creatinine methods that have not been recalibrated to be traceable to isotope dilution mass spectrometry (IDMS)]... 

I DMS-Traceable MDRD Equation (Used Only with Creatinine Methods that Have Been Recalibrated to Be Traceable to IDMS)... 

Calculate Mr VC s renal function using both Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) equations. 

Calculate CM s renal function using both the MDRD equation and the... 

They observed that the MDRD equation provided more accurate assessment of GFR than either the Cockcroft and Gault equation or measured creatinine clearance. The MDRD formula has several advantages (1) it was developed and validated in a large population, (2) it was developed with a population that included both European-Americans and African-Americans, (3) it does not require patient weight, (4) it was validated against an iothalamate clearance estimate... 

In practice, there may be little to choose between the Cockcroft and Gault formula and the more recently described MDRD equation,and which is chosen will be... 

The MDRD equation was derived from a study evaluating GFR in patients with CKD (GFR <90 mL/min). Some practitioners are advocating the use of this equation in patients without CKD, although it appears to have a weaker correlation with GFR than the Cockcroft-Gault equation. Therefore current evidence suggests that the MDRD equation should be reserved for patients with GFR <90 ml7min. 

Recently, a modified four-variable version of the original MDRD equation has been proposed for predicting GFR ... 

This equation, based on plasma creatinine, age, sex, and race, has been validated in the MDRD study sample, and is now recommended by the NKF for estimating GFR in patients with CKD and a GFR < 90 mL/min per 1.73 m in the updated NKF K/DOQI guidelines. The accuracy of these MDRD equations in estimating GFR in individuals with normal renal function those with diabetes pediatric, elderly, and obese patients and for drug dosage adjustment requires further evaluation. 

Alternatively, use of newer methods to estimate GFR, such as the MDRD equation, or the linear decline in the reciprocal of the serum creatinine concentration as a function of time, are simple clinical tools that can be used to evaluate the rate of progression of renal disease, and to predict the time when dialysis will be needed. Under... 

The Modification of Diet in Renal Disease (MDRD) equation was developed from an extensive sample of patients with known CKD, all of whom had a measured GFR <90 ml/min/1.73 m [4]. This equation is now widely reported by clinical laboratories around the world whenever Scr is measured. Since the MDRD equation overestimates measured GFR in subjects with values >60 ml/min/1.73 m, values are only reported for GFR <60 ml/min/1.73 m [3]. Use of IDMS-traceable creatinine values in the IDMS-MDRD Study equation results in a more accurate eGFR. 

The CKD-EPI equation, derived from studies including people with and without CKD, is more accurate than the MDRD equation, particularly at higher levels of GFR [5, 7]. 

The National Kidney Foundation (NKF) developed a classification system for CKD (Table 23-11.1 The staging system defines the stages of CKD based on GFR level, but also accounts for evidence of kidney damage in the absence of changes in GFR, as in stage 1 CKD. The GFR is calculated using the abbreviated Modification of Diet in Renal Disease (MDRD) study equation ... 

When to stop metformin in people with diabetes mellitus and abnormal renal function continues to be debated. It has been suggested that it should not be used in those with an eGFR (MDRD) of less than 60 ml/minute (122). However, this would exclude many people who have been taking metformin for many years without apparent ill effect. Others have recommended using the Cockcroft-Gault equation (SEDA-29, 527), which is preferable. 

An alternative to the measurement of the Ccr is the use of either nomograms or formulae to estimate the glomerular filtration rate. The two most widely used equations are the Cockcroft-Cault and the Modifica-hon of Diet in Renal Disease (MDRD) study equations [46,47]. 

Reexpressed MDRD Study equation for standardized serum creatinine [51 [ ... 

Estimation of creatinine clearance in vegetarians is controversial. Some clinicians advocate use of the 24-hour creatinine clearance in these patients since this method is based on the renal clearance of creatinine. The six-variable Modification of Diet in Renal Disease (MDRD) study equation (see below), which incorporates nutritional parameters such as BUN and albumin, has been suggested as an alternative approach. 

These equations were derived from multiple regression analysis of data obtained from patients enrolled in part of the Modification of Diet in Renal Disease Study (MDRD). Of the 1628 patients enrolled in the baseline phase of the study (mean GFR = 40 mL/min per 1.73 m ), 1070 were randomly assigned to a training sample, with the remaining 558 included in the validation sample. The initial regression model yielded the following six-variable equation ... 

Validity of a new (MDRD) prediction equation. Nephrol Dial Transplant 100. 

In general, there is a wide degree of scatter when values of glomerular filtration rate are predicted by these equations, although the equation derived from the MDRD study provides more accurate estimates of GFR than the other formulae or measured clearances... 

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