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.
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.
Authors: Sehoon Park; Seung Mi Lee; Joong Shin Park; Joon-Seok Hong; Ho Jun Chin; Ki Young Na; Dong Ki Kim; Kook-Hwan Oh; Kwon Wook Joo; Yon Su Kim; Hajeong Lee Journal: Clin J Am Soc Nephrol Date: 2017-06-13 Impact factor: 8.237
Authors: Hilde B Lauritzen; Tricia L Larose; Torbjørn Øien; Jon Ø Odland; Margot van de Bor; Geir W Jacobsen; Torkjel M Sandanger Journal: PLoS One Date: 2016-11-08 Impact factor: 3.240
Authors: Nils-Halvdan Morken; Gregory S Travlos; Ralph E Wilson; Merete Eggesbø; Matthew P Longnecker Journal: PLoS One Date: 2014-07-08 Impact factor: 3.240