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A comparison of different methods for the determination of glomerular filtration rate in elderly patients with chronic renal failure

  • Nephrology – Original Paper
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Abstract

Objective

The aim of the present study was to asses the accuracy of prediction equations in elderly patients with advanced renal disease (ARD).

Patients and methods

Twenty-three elderly patients (>60 years) with chronic kidney disease (CKD) stages 3–5 underwent technetium-99 m-diethylenetriaminepentaacetic acid (Tc-99m-DTPA) radionuclide measurement of glomerular filtration rate (GFR). To predict GFR, estimation formulas [Cockcroft-Gault (CG), 6-variable Modification of Diet in Renal Disease (6-var-MDRD) and the corrected 24-hour creatinine clearance (24-h CCL) method] were used. Estimates of bias and precision were obtained to compare prediction equations of GFR with standard radionuclide measurement.

Results

In the present study, all the prediction equations overestimated the GFR measured with the radionuclide method. Six-var-MDRD and 24-h CCL methods correlated better with standard radionuclide measurements compared to the CG formula (Rc of 0.53 and 0.50 vs. 0.41, respectively) as for GFR prediction, but they were still insufficiently accurate.

Conclusion

Glomerular filtration rate prediction equations correlate poorly with standard radionuclide measurements and their use may lead to late initialization of renal replacement therapy in elderly patients with ARD. Therefore, measurement by standard radionuclide method (Tc-99m-DTPA) is recommended to accurately assess GFR in elderly patients with ARD.

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Authors and Affiliations

  1. Department of Nephrology, Erzurum District Training and Research Hospital, 25070, Erzurum, Turkey

    Beyza Macunluoğlu & Ali Borazan

  2. Department of Pediatric Nephrology, Erzurum District Training and Research Hospital, 25070, Erzurum, Turkey

    İbrahim Gökçe

  3. Department of Nephrology, Giresun Training and Research Hospital, Giresun, Turkey

    Aydın Atakan

  4. Department of Nuclear Medicine, Erzurum District Training and Research Hospital, 25070, Erzurum, Turkey

    Münir Demirci

  5. Department of Nephrology, Marmara University Medical Faculty, 34662, Altunizade, Istanbul, Turkey

    Elif Arı

  6. Department of Public Health, Marmara University Medical Faculty, 34662, Altunizade, Istanbul, Turkey

    Ahmet Topuzoğlu

Authors
  1. Beyza Macunluoğlu
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  2. İbrahim Gökçe
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  3. Aydın Atakan
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  4. Münir Demirci
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  5. Elif Arı
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  6. Ahmet Topuzoğlu
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  7. Ali Borazan
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Correspondence to Beyza Macunluoğlu.

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Macunluoğlu, B., Gökçe, İ., Atakan, A. et al. A comparison of different methods for the determination of glomerular filtration rate in elderly patients with chronic renal failure. Int Urol Nephrol 43, 257–263 (2011). https://doi.org/10.1007/s11255-010-9846-0

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  • DOI: https://doi.org/10.1007/s11255-010-9846-0

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