ASSESSMENT OF RENAL FUNCTION BY DIFFERENT GFR ESTIMATION METHODS IN A RURAL POPULATION OF BANGLADESH

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E-Poster

Abstract Title

First Name *

MAA

Last Name *

Chowdhury

Co-author 1

MM Iqbal masud_1232001@yahoo.com NIKDU & KDRG Nephrology Dhaka

Co-author 2

Md Nasir Uddin kdrgbd@yahoo.com NIKDU Nephrology Dhaka

Co-author 3

KS Alam kshahnoor@yahoo.com NIKDU Nephrology Dhaka

Co-author 4

SK B anerjee drsajalk2003@yahoo.com BSMMU Cardiology Dhaka

Co-author 5

Sohel Reza Choudhury sohel_r_choudhury@hotmail.com NHFH&RI Epidemiology And Research Dhaka

Co-author 6

Dipal K Adhikary dka_1965@yahoo.com BSMMU Cardiology Dhaka

Co-author 7

Rana M Hossain rm_hossain@yahoo.com BSMMU Nephrology Dhaka

Co-author 8

Md Zahid Hassan mzhassan@buhs.ac.bd BUHS Physiology and Molecular Biology Dhaka

Co-author 9

MS Hassan mshassan1950@yahoo.com BIRDEM Immunology Dhaka

Co-author 10

MN Islam nazrul.rita@gmail.com DMCH Nephrology Dhaka

Co-author 11

Sarwar Iqbal sarwariqbal2003@yahoo.com KDRG Nephrology Dhaka

Co-author 12

MI Arslan iqbalarslan@yahoo.com KDRG Biochemistry Dhaka

Co-author 13

Co-author 14

Co-author 15

Introduction

Proper measurement of renal function is important for diagnosis and stratification of kidney disease. Though several methods have been used to estimate the glomerular filtration rate, results have been variable depending on the population studied. This study was undertaken to estimate and compare different creatinine and cystatin C based GFRs to see their agreement with each other.

Methods

This cross-sectional study was conducted on random 222 participants of a rural area. Detail medical history was taken along with available relevant investigations from each patient. The eGFR was estimated using creatinine-based C-G (Cockcroft-Gault), MDRD, CKD-EPI methods and creatinine and cystatin C based formula methods.

Results

Mean age of the study population was 41±12 years with a majority in 31-50 years of age (59%) where male were 53%. Hypertensive subjects were 11% and diabetes was present in 7%. Mean eGFR measured by creatinine based MDRD, C&G (Cockcroft-Gault) and CKD-EPI were 117±25, 102±30 and 119±20 mL/min/1.73 m2 (p=NS). Mean eGFR measured by cystatin C based equation was 107±16 and by both creatinine and cystatin C was 105±20 mL/min/1.73 m2 (p=NS). Comparisons of eGFR by Bland-Altman plot in the study subjects showed some bias between all methods. Here data were skewed and a wide range for the limit of agreement.

The distribution of the frequency of CKD stages varied significantly when each of the formulas applied by creatinine and cystatin C based methods. The stage distribution pattern by MDRD formula of G1, G2 and G3 was 86.5%, 12.6% & 0.9% ; by C-G 68.0%, 22.1% & 9.9% and by CKD-EPI 88.7%, 10.4% & 0.9%. The pattern for cystatin C based formula found only stage G1 and G2 of 87.8% &12.2% . By applying both creatinine and cystatin C it was 76.6% & 23.4%.

Conclusions

GFR estimation methods revealed wide variations when the distribution pattern of CKD stages was done by different creatinine and cystatin C based formulas. Therefore, these GFR estimation methods need to be compared with an ideal measured method to identify the appropriate one.

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