Pregnancy Reduces the Accuracy of the Estimated Glomerular Filtration Rate Based on Cockroft-Gault and MDRD Formulas.

P.M. Koetje, J.J. Spaan, J.P. Kooman, M.E.A. Spaanderman, L.L.H. Peeters

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: This study aims to determine the effect of pregnancy on the accuracy of 3 commonly used methods to estimate glomerular filtration rate ([GFR] creatinine clearance, the Cockroft-Gault, and modification of diet in renal disease [MDRD] formulas) using the inulin clearance as a reference. Design: Longitudinal study design. Setting: University hospital. Population: A total of 44 parous nonsmoking Caucasian women. They had a history of uneventful pregnancy (n = 9), preeclampsia (n = 27), and intrauterine fetal demise (n = 8). Methods: Measurements were performed both in pre-pregnancy and early pregnancy (8 weeks of gestation) and included inulin infusion, blood pressure, and 24-hour urinary and serum creatinine. Agreement between methods to estimate GFR was assessed by the Bland and Altman method. Main outcome measures: GFR estimated by inulin and creatinine clearances and the Cockroft-Gault and MDRD formulas. Results: During early pregnancy, the GFR measured by inulin increased 32% compared with the pre-pregnant value (from 115 +/- 18 to 150 +/- 23 mL/min.1.73 m(-2)), whilst the GFR measured by the indirect methods only increased 20%. The observed bias and limits of agreements are larger in early pregnancy relative to the pre-pregnant state for all 3 methods. Conclusion: The renal hyperfiltration during pregnancy decreases further the accuracy of the creatinine clearance and the Cockroft-Gault and MDRD formulas to estimate GFR.
Original languageEnglish
Pages (from-to)456-462
Number of pages7
JournalReproductive Sciences
Volume18
Issue number5
DOIs
Publication statusPublished - May 2011

Keywords

  • glomerular filtration rate
  • pregnancy
  • Cockroft-Gault formula
  • MDRD formula
  • SERUM CYSTATIN-C
  • TYPE-2 DIABETIC-PATIENTS
  • PREDICTION EQUATIONS
  • CREATININE CLEARANCE
  • RENAL-FUNCTION
  • GFR
  • PREECLAMPSIA
  • HISTORY
  • MARKER
  • WOMEN

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