Is the New Mayo Clinic Quadratic Equation Useful for the Estimation of Glomerular Filtration Rate in Type 2 Diabetic Patients?

  1. Néstor Fontseré, MD, PHD1,
  2. Jordi Bonal, MD, PHD2,
  3. Isabel Salinas, MD, PHD3,
  4. Manel Ramírez de Arellano, MD1,
  5. Jose Rios, BSC4,
  6. Ferran Torres, MD, PHD4,
  7. Anna Sanmartí, MD, PHD3 and
  8. Ramón Romero, MD, PHD2
  1. 1Department of Nephrology, Hospital de Terrassa, Barcelona, Spain
  2. 2Department of Nephrology, University Hospital Germans Trias i Pujol, Barcelona, Spain
  3. 3Department of Endocrinology, University Hospital Germans Trias i Pujol, Barcelona, Spain
  4. 4Biostatistics and Epidemiology Laboratory, Universidad Autónoma de Barcelona, Barcelona, Spain
  1. Corresponding author: Néstor Fontseré, 34989nfb{at}comb.es

Abstract

OBJECTIVE—To test the Mayo Clinic Quadratic (MCQ) equation against isotopic glomerular filtration rate, compared with the Modification of Diet in Renal Disease (MDRD) and the Cockcroft-Gault formulas, in type 2 diabetes.

RESEARCH DESIGN AND METHODS—Based on values obtained with iothalamate, 118 type 2 diabetic patients were divided into three groups according to renal function: hyperfiltration (26), normal function (56), or chronic kidney disease (CKD) stages 3–4 (36). ANOVA, the Bland-Altman procedure, and Lins coefficient (Rc) were performed to study accuracy.

RESULTS—In the hyperfiltration and normal function groups, all prediction equations significantly underestimated the value obtained with isotopic glomerular filtration rate (P < 0.05). In the CKD group, all equations also presented significant differences with the isotopic method. However, MDRD had a bias of −5.3 (Rc 0.452), Cockcroft-Gault formula −0.2 (Rc 0.471), and the MCQ −4.5 (Rc 0.526).

CONCLUSIONS—The MCQ and prediction equations proved inaccurate (excessive underestimation) in type 2 diabetic patients with hyperfiltration or normal renal function. With regard to CKD, the results obtained provided no evidence of superiority of the MCQ over the MDRD or the Cockcroft-Gault formula.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 3 October 2008.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted August 29, 2008.
    • Received May 28, 2008.
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  1. Published online before print October 3, 2008, doi: 10.2337/dc08-0958 Diabetes Care December 2008 vol. 31 no. 12 2265-2267
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