Subscribe to RSS
DOI: 10.1055/s-0030-1268712
Performance of Estimated Glomerular Filtration Rate Prediction Equations in Preeclamptic Patients
Publication History
Publication Date:
18 November 2010 (online)
![](https://www.thieme-connect.de/media/ajp/201106/lookinside/thumbnails/10.1055-s-0030-1268712-1.jpg)
ABSTRACT
Accurate estimation of the glomerular filtration rate (GFR) in patients with preeclampsia requires the collection of a 24-hour urine and can have important therapeutic and diagnostic implications. This procedure is often difficult or impossible to accomplish in this patient group. In this study, the Cockcroft-Gault, the Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas were evaluated for their accuracy in determining GFR in the setting of preeclampsia. The estimated GFRs calculated from the above formulas were compared with the creatinine clearance values obtained from a 24-hour urine collections in 543 preeclamptic patients recruited from several large hospitals. Additionally, a set of new equations, preeclampsia GFR (PGFR), based on ethnicity, was created. The Cockcroft-Gault, MDRD, and CKD-EPI formulas were inaccurate in predicting GFR and both were significantly less accurate than PGFR. The latter formula provided an estimated GFR that was much closer to the creatinine clearance. Current GFR estimation equations based on serum creatinine values in nonpregnant patients are not reliable measures of renal function in patients with preeclampsia. The use of a new formula (PGFR) is recommended.
KEYWORDS
Glomerular filtration rate - preeclampsia - pregnancy
REFERENCES
- 1 Lindheimer M D, Davison J M, Katz A I. The kidney and hypertension in pregnancy: twenty exciting years. Semin Nephrol. 2001; 21 173-189
- 2 Rahn K H, Heidenreich S, Brückner D. How to assess glomerular function and damage in humans. J Hypertens. 1999; 17 309-317
- 3 Levey A S. Measurement of renal function in chronic renal disease. Kidney Int. 1990; 38 167-184
- 4 Quadri K H, Bernardini J, Greenberg A, Laifer S, Syed A, Holley J L. Assessment of renal function during pregnancy using a random urine protein to creatinine ratio and Cockcroft-Gault formula. Am J Kidney Dis. 1994; 24 416-420
- 5 Cockcroft D W, Gault M H. Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16 31-41
- 6 Levey A S, Bosch J P, Lewis J B et al.. A more accurate method to estimate glomerular filtration from serum creatinine: a new prediction equation. Modification of diet in Renal Disease Study Group. Ann Intern Med. 1999; 130 461-470
- 7 Levey A S, Stevens L A, Schmid C H CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150 604-612
- 8 Alper A B, Yi Y, Webber L S et al.. Estimation of glomerular filtration rate in preeclamptic patients. Am J Perinatol. 2007; 24 569-574
- 9 von Dadelszen P, Payne B, Menzies J M for the PIERS Study Group et al. Predicting adverse maternal outcomes in pre-eclampsia: the full PIERS (Pre-eclampsia Integrated Estimate of RiSk) model—development and validation. Lancet. In press
- 10 Côté A M, Lam E M, von Dadelszen P, Mattman A, Magee L A. Monitoring renal function in hypertensive pregnancy. Hypertens Pregnancy. 2010; 29 318-329
- 11 Ibrahim H, Mondress M, Tello A, Fan Y, Koopmeiners J, Thomas W. An alternative formula to the Cockcroft-Gault and the modification of diet in renal diseases formulas in predicting GFR in individuals with type 1 diabetes. J Am Soc Nephrol. 2005; 16 1051-1060
- 12 Vervoort G, Willems H L, Wetzels J F. Assessment of glomerular filtration rate in healthy subjects and normoalbuminuric diabetic patients: validity of a new (MDRD) prediction equation. Nephrol Dial Transplant. 2002; 17 1909-1913
- 13 Stevens L A, Manzi J, Levey A S et al.. Impact of creatinine calibration on performance of GFR estimating equations in a pooled individual patient database. Am J Kidney Dis. 2007; 50 21-35
Jules PuschettM.D.
Texas A&M Health Science Center, College of Medicine/Scott & White
2401 S. 31st Street, Medical Education Building, 407 L, Temple, TX 76508
Email: jpuschett@swmail.sw.org