Korean J Intern Med.  2016 Mar;31(2):344-356. 10.3904/kjim.2015.227.

Validation of the Korean coefficient for the modification of diet in renal disease study equation

Affiliations
  • 1Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea.
  • 2Department of Internal Medicine, National Medical Center, Seoul, Korea.
  • 3Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Epidemiology and Biostatistics, Seoul National University School of Public Health, Seoul, Korea.
  • 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. yonsukim@snu.ac.kr

Abstract

BACKGROUND/AIMS
Race and ethnicity are important determinants when estimatingglomerular filtration rate (GFR). The Korean coefficients for the isotope dilution mass spectrometry (IDMS) Modification of Diet in Renal Disease (MDRD) Study equations were developed in 2010. However, the coefficients have not been validated. The aim of this study was to validate the performance of the Korean coefficients for the IDMS MDRD Study equations.
METHODS
Equation development and validation were performed in separate groups (development group, n = 147 from 2008 to 2009; validation group, n = 125 from 2010 to 2012). We compared the performance of the original IDMS MDRD equations and modified equations with Korean coefficients. Performance was assessed by comparing correlation coefficients, bias, and accuracy between estimated GFR and measured GFR, with systemic inulin clearance using a single injection method.
RESULTS
The Korean coefficients for the IDMS MDRD equations developed previously showed good performance in the validation group. The new Korean coefficients for the four- and six-variable IDMS MDRD equations using both the development and validation cohorts were 1.02046 and 0.97300, respectively. No significant difference was detected for the new Korean coefficients, in terms of estimating GFR, between the original and modified IDMS MDRD Study equations.
CONCLUSIONS
The modified equations with Korean coefficients for the IDMS MDRD Study equations were not superior to the original equations for estimating GFR. Therefore, we recommend using the original IDMS MDRD Study equation without ethnic adjustment in the Korean population.

Keyword

Coefficients; Glomerular filtration rate; Equation; Inulin clearance

MeSH Terms

Adult
Aged
*Asian Continental Ancestry Group
Biomarkers/blood
Case-Control Studies
Chromatography, High Pressure Liquid
Creatinine/blood
Female
*Glomerular Filtration Rate
Humans
Indicator Dilution Techniques
Inulin/administration & dosage/blood
Kidney/*physiopathology
Male
Mass Spectrometry
Middle Aged
*Models, Biological
Oligosaccharides/administration & dosage/blood
Predictive Value of Tests
Renal Insufficiency, Chronic/blood/*diagnosis/ethnology/physiopathology
Reproducibility of Results
Republic of Korea
Biomarkers
Creatinine
Inulin
Oligosaccharides
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