Original InvestigationPathogenesis and Treatment of Kidney DiseaseComparison of Drug Dosing Recommendations Based on Measured GFR and Kidney Function Estimating Equations
Section snippets
Sources of Data
The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) is a research group formed to develop and validate improved estimating equations for GFR by pooling data from research studies and clinical populations (hereafter referred to as “studies”), which include individuals with diverse clinical characteristics with and without kidney disease across a wide range of GFRs. Methods for identification of and inclusion criteria for these studies have been previously described.2 The population
Study Population
Clinical characteristics of the 5,504 participants included in the study population are listed in Table 2. Mean age of the cohort is 47 ± 15 years. Approximately a third of the cohort was African American, a similar number had diabetes, and 5% were kidney transplant recipients. Mean measured GFR was 75 ± 44 mL/min; eGFR from the MDRD Study equation and estimated creatinine clearances from the CG and CGIBW equations were 69 ± 38, 75 ± 42, and 62 ± 36 mL/min, respectively. All pairwise
Discussion
Accurate estimates of kidney function are essential for optimal dosing of drugs cleared by the kidney. Overestimates of kidney function may lead to administration of inappropriately large doses and possible toxicity, and conversely, underestimates may lead to subtherapeutic dosing, treatment failures, and prolonged illness. In this study, we showed that the MDRD Study equation had the greatest rate of concordance with measured GFR for both assignment of kidney function categories recommended by
Acknowledgements
A list of the Investigators of CKD-EPI Aims 1 and 2, organized by institution, follows. Tufts Medical Center, Boston, MA: Andrew S. Levey, MD; Lesley A. Stevens, MD, MS; Christopher H. Schmid, PhD; and Yaping (Lucy) Zhang, MS. Cleveland Clinic Foundation, Cleveland, OH: Frederick Van Lente, PhD; and Liang Li, PhD. University of Utah, Salt Lake City, UT: Tom Greene, PhD. Johns Hopkins University, Baltimore, MD: Josef Coresh, MD, PhD, MHS; Jane Manzi, PhD; Brad Astor, PhD, MPH; and Elizabeth
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Originally published online as doi: 10.1053/j.ajkd.2009.03.008 on May 18, 2009.
A list of the CKD-EPI investigators and collaborators appears at the end of this article.
Because an author of this manuscript is an editor for AJKD, the peer-review and decision-making processes were handled entirely by an Associate Editor (Kamal Badr, MD, Lebanese American University) who served as Acting Editor-in-Chief. Details of the journal's procedures for potential editor conflicts are given in the Editorial Policies section of the AJKD website.