Modification of diet in renal disease MDRD , equation

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

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 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 ... 

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 ... 

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