Association of Different Egfr Methods, Calcium Metabolism and Anemia in Diabetic Chronic Kidney Disease: an Indian Perspective (experience)

The aim was to evaluate performance of Cockcroft Gault (CG), modification of diet in renal disease (MDRD) formula in the prediction of glomerular filtration rate (GFR) as compared to 51Cr-EDTA GFR (isotope GFR) in diabetic chronic kidney disease (dCKD) and their relation with calcium and iron metabolism parameters. One hundred ambulatory patients with diabetes without nephrotic syndrome, renal replacement, renal transplantation or any severe coexisting illness underwent clinical assessment, blood collection after overnight fast and isotope GFR estimation using Cr51-EDTA. Advanced CKD (GFR <30 mL/min/1.73m2) was found in 42.5% of patients. Compared to isotope GFR, CG formula and MDRD equation overestimated and underestimated GFR, respectively, with CG having a lower diagnostic accuracy. Correlation between parathormone and isotope GFR was maximal in CKD stage 4. The odds ratio for anemia for GFR <30mL/min/1.73m2 was 2.21. In conclusion, MDRD is a better predictor of renal function as compared to CG in Indian dCKD patients.