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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Swedko et al¹ make a strong case for the limitations of serum creatinine in predicting or monitoring renal function, especially in elderly patients. All of us who provide primary care need to be aware of this important point.

They offer the Cockroft-Gault (C-G) equation as an alternative that is easy to calculate and that better approximates GFR. This equation was originally validated primarily for male patients and does not account for variables such as ethnicity. Further, in reviews by the National Kidney Foundation (NKF),¹ only 75% of estimates of GFR using the C-G equation were within 30% of the measured GFR.

As part of our efforts to improve the care of patients with impaired renal function in our Family Practice Residency Program (San Francisco General Hospital), we found that the NKF recommends the Modification of Diet in Renal Disease (MDRD) Study equation² (also known as the Levey equation).³ It differs . . . [Full Text of this Article]

Susannah Bernheim, MD; Steve Chen, MD; Michele Gomez, MD; Reini Jensen, MD; Lori Kohler, MD; Lester Love, MD; Teresa Villela, MD; Michelle Winscott, MD
San Francisco, Calif

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A Better Alternative for Estimating Renal Function—Reply
Peter J. Swedko, Heather D. Clark, and Ayub Akbari
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