Korean Journal of Nephrology 2008;27(5):560-568.
Comparison of Various Methods for Estimating Glomerular Filtration Rate in Patients with Chronic Kidney Disease
Dong Hyun Kim, M.D.1, Shin-Wook Kang, M.D.1, Kwang Il Ko, M.D.1, Chan Ho Kim, M.D.1, Ju Hyun Lee, M.D.2, Jin Ha Lee, M.D.1, Eun Young Kim, M.D.1, Jung Tak Park, M.D.1 , Tae Ik Chang, M.D.1, Hyun Wook Kim, M.D.1, Sun Young Park, M.D.1, Jae Hyun Chang, M.D.
Department of Internal Medicine1
Yonsei University College of Medicine, Department of Internal Medicine2
National Health Insurance Corporation Ilsan Hospital
원저 : 만성 신질환 환자에서 여러 가지 사구체 여과율 산출 방법간의 비교
김동현1, 강신욱1, 고광일1, 김찬호1, 이주현2, 이진하1, 김은영1, 박정탁1, 장태익1, 김현욱1, 박선영1, 장제현1, 김동기1, 유태현1, 한대석1
연세대학교 의과대학 내과학교실1, 국민건강보험공단 일산병원 내과2
Abstract
Purpose : Several methods are used to estimate glomerular filtration rate (GFR), but there are limitations in each method. We investigated the variation in GFR measured by different methods in patients with chronic kidney disease (CKD). Methods : 549 patients with CKD stages 2-5, who underwent creatinine clearance (Ccr) and 99mTc-DTPA renal scan, were enrolled. GFR was calculated by using Cockcroft-Gault equation (CG-GFR) and MDRD equation (MDRD-GFR). The correlations between MDRD-GFR and GFR estimated by other methods were analyzed according to CKD stages and age groups (<40, 40-59, and≥60 years). Results : The mean age of patients was 55±19 year (male 60%). CG-GFR, Ccr, and estimated GFR by 99mTc-DTPA renal scan (DTPA-GFR) correlated significantly with MDRD-GFR in all CKD stages and all age groups (p<0.01). Compared to patients with stages 2-4 CKD, however, the possibilities of CGGFR, Ccr, and DTPA-GFR to be within 30% of MDRD-GFR were significantly lower in stage 5 CKD patients (p<0.05). In addition, the ratio of DTPA-GFR/MDRD-GFR in stage 5 CKD patients was 2.24 ±1.40, indicating overestimation of DTPA-GFR in these patients. On the other hand, the accuracy of various GFR-estimating methods was higher in patients aged more than 60 years compared to the others. Conclusion : CG-GFR, Ccr, and DTPA-GFR correlated significantly with MDRD-GFR, but there was a wide variation in GFR estimated by various methods. Therefore, a careful interpretation of estimation in GFR is needed according to the stage of CKD and the age of patients.
Key Words: Glomerular filtration rate


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