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Diabetologia
Published in: Diabetologia 6/2011

01-06-2011 | Article

The four-variable modification of diet in renal disease formula underestimates glomerular filtration rate in obese type 2 diabetic individuals with chronic kidney disease

Authors: S. Nair, V. Mishra, K. Hayden, P. J. G. Lisboa, B. Pandya, S. Vinjamuri, K. J. Hardy, J. P. H. Wilding

Published in: Diabetologia | Issue 6/2011

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Abstract

Aims/hypothesis

GFR is commonly estimated using the four-variable Modification of Diet in Renal Disease (MDRD) formula and this forms the basis for classification of chronic kidney disease (CKD). We investigated the effect of obesity on the estimation of glomerular filtration rate in type 2 diabetic participants with CKD.

Methods

We enrolled 111 patients with type 2 diabetes mellitus in different stages of CKD. GFR was measured using 51Cr-labelled EDTA plasma clearance and was estimated using the four-variable MDRD formula.

Results

The bias between estimated and measured GFR was −22.4 (−33.8 to −11.0) p < 0.001 in the obese group compared with −6.04 (−17.6 to −5.5) p = 0.299 in the non-obese group. When GFR was indexed to body surface area of 1.73 m2, the bias remained significant at −9.4 (−13.4 to −5.4) p < 0.001 in the obese participants.

Conclusions/interpretation

This study suggests that the four-variable MDRD formula significantly underestimates GFR in obese type 2 diabetic participants with CKD.
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Metadata
Title
The four-variable modification of diet in renal disease formula underestimates glomerular filtration rate in obese type 2 diabetic individuals with chronic kidney disease
Authors
S. Nair
V. Mishra
K. Hayden
P. J. G. Lisboa
B. Pandya
S. Vinjamuri
K. J. Hardy
J. P. H. Wilding
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 6/2011
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-011-2085-9

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