An evaluation of the performance of Cockcroft–Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease–Epidemiology Collaboration equations in estimating glomerular filtration rate among at-risk adults: A community-based study
Rotimi Williams Braimoh, Ale Olagoke Korede, Bello Taslim BabawaleABSTRACT
Background:
Late presentation of chronic kidney disease (CKD) remains a major challenge in sub-Saharan Africa, contributing to preventable morbidity and mortality. Early identification of reduced kidney function is essential for timely intervention. Although estimated glomerular filtration rate (eGFR) equations are widely used, their performance in community-based at-risk populations is not well established.
Methods:
This community-based study evaluated the performance of three eGFR equations – CKD–Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD), and Cockcroft–Gault (CG) – among at-risk adults, using creatinine clearance (CrCl) (which may overestimate true glomerular filtration rate [GFR]) as the reference standard. Key performance metrics included sensitivity, specificity, precision, negative predictive value (NPV), and P30 accuracy (proportion of estimates within ± 30% of measured GFR); metrics are interpreted as relative, given that CrCl may overestimate true GFR. CKD classification was based solely on GFR thresholds.
Results:
The mean age was 41.8 ± 12.7 years, and 58.5% (
Conclusion:
The performance of eGFR equations varies in community screening settings. CKD-EPI slightly overestimates GFR but still provides the most accurate estimates and may be preferable for the identification of impaired kidney function in at-risk populations.