BACKGROUND: Glomerular filtration rate (GFR) has major prognostic implications in heart failure. Our objective was to validate the MDRD prediction equations for GFR in patients with advanced heart failure, and to compare their predictive performance to that of the Cockcroft-Gault (CG) equation. METHODS: We analysed GFR in 45 patients referred for heart transplantation evaluation. 51Cr-EDTA-measured GFR was compared to GFR estimates obtained by MDRD1 and MDRD2 equations, CG equation using actual body weight, and ideal body weight. Regression analyses and Pearson correlations were performed, and Bland and Altman plots were drawn. ROC curves were obtained to illustrate each equation's ability to predict a GFR less than 60 ml/min/1.73 m2 (moderate renal impairment). RESULTS: Patients had a mean age of 52 years, and 69% were in NYHA class III. The mean EDTA-measured GFR was 46.9+/-17.2 ml/min/1.73 m2. The MDRD1 equation provided the best predictive model (narrowest limits of agreement; r = 0.766, p < 0.001), and the highest performance in predicting a GFR less than 60 ml/min/1.73 m2 (area under curve: 0.901). CONCLUSIONS: MDRD equations, especially MDRD1, adequately predict GFR in advanced heart failure, with higher accuracy than the CG equation. MDRD1 also has higher performance in predicting a GFR less than 60 ml/min/1.73 m2.
BACKGROUND: Glomerular filtration rate (GFR) has major prognostic implications in heart failure. Our objective was to validate the MDRD prediction equations for GFR in patients with advanced heart failure, and to compare their predictive performance to that of the Cockcroft-Gault (CG) equation. METHODS: We analysed GFR in 45 patients referred for heart transplantation evaluation. 51Cr-EDTA-measured GFR was compared to GFR estimates obtained by MDRD1 and MDRD2 equations, CG equation using actual body weight, and ideal body weight. Regression analyses and Pearson correlations were performed, and Bland and Altman plots were drawn. ROC curves were obtained to illustrate each equation's ability to predict a GFR less than 60 ml/min/1.73 m2 (moderate renal impairment). RESULTS:Patients had a mean age of 52 years, and 69% were in NYHA class III. The mean EDTA-measured GFR was 46.9+/-17.2 ml/min/1.73 m2. The MDRD1 equation provided the best predictive model (narrowest limits of agreement; r = 0.766, p < 0.001), and the highest performance in predicting a GFR less than 60 ml/min/1.73 m2 (area under curve: 0.901). CONCLUSIONS: MDRD equations, especially MDRD1, adequately predict GFR in advanced heart failure, with higher accuracy than the CG equation. MDRD1 also has higher performance in predicting a GFR less than 60 ml/min/1.73 m2.
Authors: Marco Metra; Luca Bettari; Franca Pagani; Valentina Lazzarini; Carlo Lombardi; Valentina Carubelli; Graziella Bonetti; Silvia Bugatti; Giovanni Parrinello; Luigi Caimi; G Michael Felker; Livio Dei Cas Journal: Clin Res Cardiol Date: 2012-03-10 Impact factor: 5.460
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Authors: Margarida Alvelos; Rodrigo Pimentel; Elika Pinho; André Gomes; Patricia Lourenço; Maria José Teles; Pedro Almeida; João Tiago Guimarães; Paulo Bettencourt Journal: Clin J Am Soc Nephrol Date: 2010-11-29 Impact factor: 8.237
Authors: Lesley A Stevens; Thomas D Nolin; Michelle M Richardson; Harold I Feldman; Julia B Lewis; Roger Rodby; Raymond Townsend; Aghogho Okparavero; Yaping Lucy Zhang; Christopher H Schmid; Andrew S Levey Journal: Am J Kidney Dis Date: 2009-05-17 Impact factor: 8.860
Authors: Alain Cohen-Solal; Dipak Kotecha; Dirk J van Veldhuisen; Daphne Babalis; Michael Böhm; Andrew J Coats; Michael Roughton; Philip Poole-Wilson; Luigi Tavazzi; Marcus Flather Journal: Eur J Heart Fail Date: 2009-08-01 Impact factor: 15.534