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COMMENTS AND OPINIONS
Glomerular Filtration Rate Results Reflect Estimation
Micah L. Thorp, DO, MPH
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In their excellent article, Ensrud and colleagues1 found a significant relationship between estimated glomerular filtration rates (eGFRs) and fractures among elderly white women with mild chronic kidney disease (CKD). Interestingly, the relationship was only significant when the Cockcroft-Gault method was used to calculate eGFR. When the 4 variable Modification of Diet in Renal Disease (MDRD) equation was applied, the association was not significant. One possible explanation for the discrepancy noted by Sprague2 in his accompanying editorial may be an underestimation of GFR by the MDRD equation among patients with moderate CKD.
Another explanation may be differences in variation in estimation equations. If the MDRD equation had greater variability than the Cockcroft-Gault equation at moderate levels of GFR, a relationship between GFR and fractures would be less apparent. Simply stated, among patients with the same eGFR, those with bone fractures may simply have a lower GFR . . . [Full Text of this Article]
AUTHOR INFORMATION
RELATED LETTER
Glomerular Filtration Rate Results Reflect Estimation—Reply
Kristine E. Ensrud, Areef Ishani, Brent C. Taylor, and Li-Yung Lui
Arch Intern Med. 2007;167(17):1906.
EXTRACT
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RELATED ARTICLES
Renal Function and Risk of Hip and Vertebral Fractures in Older Women: Is It Always Osteoporosis?
Stuart M. Sprague
Arch Intern Med. 2007;167(2):115-116.
EXTRACT
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Renal Function and Risk of Hip and Vertebral Fractures in Older Women
Kristine E. Ensrud, Li-Ying Lui, Brent C. Taylor, Areef Ishani, Michael G. Shlipak, Katie L. Stone, Jane A. Cauley, Sophie A. Jamal, Diana M. Antoniucci, Steven R. Cummings, and for the Study of Osteoporotic Fractures Research Group
Arch Intern Med. 2007;167(2):133-139.
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