Comparison of GFR Estimating Equations with Creatinine Clearance among Patients who Visit Renal Unit of Tikur Anbessa Specialized Hospital

Addisu, Kassa Setegn (2014) Comparison of GFR Estimating Equations with Creatinine Clearance among Patients who Visit Renal Unit of Tikur Anbessa Specialized Hospital. Masters thesis, Addis Ababa University.

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Abstract

Background: Glomerular Filtration Rate (GFR) is the amount of plasma filtered through glomerular capillaries of both kidneys per minute. It is used to measure the function of kidney and to know its status. GFR measurement can be done by using endogenous and exogenous filtration markers. But this measurement is expensive, time consuming and inconvenient to patients. To alleviate these problem we can estimate GFR by using Cockcroft- Gault, MDRD and CKD–EPI equations.GFR estimating equations are affected by sex, age, race, muscle mass, weight and height of an individual. However, the relation GFR estimating equations with creatinine clearance using these physiologic variables have not been clearly evaluated in Ethiopia. Hypothesis: The current study hypothesized that there will be a difference between GFR estimating equations (CG, MDRD and CKD-EPI) and creatinine clearance. Objective: The objective of study was to compare GFR estimating equations with creatinine clearance among patients who visit renal unit of Tikur Anbessa Specialized Hospital. Materials and Methods: Cross sectional study was conducted to compare GFR estimating equations with that of creatinine clearance among 123 patients who visit renal unit of TASH from May 20 to April 16 / 2013. A convenient sampling was used in the study to select the study participants. Data was collected by using questionnaire, test tube, 5ml syringe with needle, urine collecting bag, balance and meter. Five ml of venous blood and 24 hour urine were taken from each participant to determine serum and urine creatinine concentration respectively. Serum creatinine was determined by using fully automated HITACHI 902 chemistry analyzer. Whereas, urine creatinine concentration was determined by using automated autolab 18 chemistry analyzer. Descriptive statistic, Paired sample t test, Bland-Altman analysis and correlation were carried out.P-value < 0.05 was considered as statistical significant and 95% CI used. Result: Of 123 study participants 52 (42.3%) were males and 71 (57.7%) were females. Their mean age was 39.9 + 16.7 years. Mean GFR were 49.59+ 32.40, 56.15+33.70, 65.53+52.80 and80.52+80.52 ml/min with creatinine clearance, Cockroft-Gault, MDRD and CKD-EPI respectively. GFR estimating equations significantly overestimate mGFRCcr by 6.56, 15.94 and 30.93 ml/min with CG, MDRD and CKD- EPI respectively (p <0.05). Strong, positive and significant correlations were observed between Ccr and GFR estimating equations. The Pearson’s correlation coefficients (r) were 0.719, 0.760 and 0.771 with CG, MDRD and CKDEPI vs. Ccr respectively (P = 0.00).Accuracy of participants classification at lower GFR levels (GFR <30 ml/min ) with MDRD was ranged from 0.98-1 and with CG at higher GFR levels (GFR >30 ml/min) was from 0.94-0.98.Limit of agreement were from -43.03 -48.59,-53- 85.30 and -42.04 - 103.90 with CG, MDRD and CKD-EPI vs. Ccr respectively. Conclusion: Overall comparison of the three GFR estimating equations with creatinine clearance showed that CG estimate GFR better than MDRD and CKD-EPI equations. Furthermore, better GFR estimation with MDRD was observed next to CG. In the current study strong, positive and significant correlation and good measurement agreement were observed between Ccr and CKDEPI.However; it is less effective to estimate GFR as compared with CG and MDRD.

Item Type:	Thesis (Masters)
Subjects:	Q Science > QP Physiology R Medicine > R Medicine (General)
Divisions:	Africana
Depositing User:	Emmanuel Ndorimana
Date Deposited:	04 Jul 2018 14:54
Last Modified:	04 Jul 2018 14:54
URI:	http://thesisbank.jhia.ac.ke/id/eprint/6642

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