Estimates of glomerular filtration rate : comparison of different creatinine based equations /

Kidney disease is a worldwide health concern with an increasing number of patients and its associated mortality in the past 10 years. End stage renal disease is a major cost driver in our health-care system where the annual rate of dialysis has been increasing over the past two decades. Therefore, i...

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Bibliographic Details
Main Author: Farah Nadia Mohd Hanafiah (Author)
Format: Thesis
Language:English
Published: Kuantan, Pahang : Kulliyyah of Medicine, International Islamic University Malaysia, 2020
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Online Access:Click here to view 1st 24 pages of the thesis. Members can view fulltext at the specified PCs in the library.
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008 210119s2020 my a f m 000 0 eng d
040 |a UIAM  |b eng  |e rda 
041 |a eng 
043 |a a-my--- 
100 0 |a Farah Nadia Mohd Hanafiah,  |e author 
245 1 |a Estimates of glomerular filtration rate :  |b comparison of different creatinine based equations /  |c by Farah Nadia binti Mohd Hanafiah 
264 1 |a Kuantan, Pahang :  |b Kulliyyah of Medicine, International Islamic University Malaysia,  |c 2020 
300 |a xiii, 74 leaves :  |b illustrations ;  |c 30cm. 
336 |2 rdacontent  |a text 
337 |2 rdamedia  |a unmediated 
338 |2 rdacarrier  |a volume 
338 |2 rdacarrier  |a online resource 
347 |2 rdaft  |a text file  |b PDF 
500 |a Abstracts in English. 
500 |a "A dissertation submitted in fulfilment of the requirement for the degree of Master of Medicine (Anaesthesiology)." --On title page. 
502 |a Thesis (MMA)--International Islamic University Malaysia, 2020. 
504 |a Includes bibliographical references (leaves 66-71). 
520 |a Kidney disease is a worldwide health concern with an increasing number of patients and its associated mortality in the past 10 years. End stage renal disease is a major cost driver in our health-care system where the annual rate of dialysis has been increasing over the past two decades. Therefore, it is important to identify kidney disease at an earlier stage in order to slow the progression of kidney dysfunction through inexpensive interventions. The Kidney Disease Improving Global Outcomes (KDIGO) guideline advocates the use of estimated glomerular filtration equation (eGFR) to estimate renal function. However, to the best of knowledge, all of the equations developed has not been validated for the Malaysian population. We evaluated the performance of Cokcroft Gault (CG), Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations for estimating GFR taking into account ethnicity, BMI and age group. This was a cross sectional study using the existing record of patients that was referred for 99mTc-DTPA scan at the Breast Centre of International Islamic University Malaysia. Data were collected from patient's clinical record whom were referred from Urology department of Hospital Tengku Ampuan Afzan and IIUM Medical Centre. The records were taken from patients visiting the centre from January 2016 to December 2019. All estimated GFR were analysed in relation to the measured GFR by 99mTc-DTPA scan. A total of 126 patients' data was collected. The mean measured GFR by 99mTc-DTPA scan was 42.2 ± 20.38 ml/min, these was lower than that estimated by CG, MDRD and CKD-EPI equations (53.81 ± 36.11, 53.65 ± 34.24 and 53.28 ± 32.9 ml/min, respectively). CKD-EPI had the highest correlation to measured GFR with correlation coefficient of 0.72 (p<0.001). MDRD had the highest accuracy with accuracy between 30% and 50% between 45.24% and 67.46%. However CKD-EPI had the least bias (mean bias of 11.08 ± 23.08), and was more precise (r2 of 0.4) compared to MDRD and CG. In patients younger than 65 year old, CKD-EPI had the highest correlation of 0.75 (p<0.001), whilst MDRD had the highest correlation of 0.46 (p<0.05) in patients who were more than 65 years old. CKD-EPI had the highest correlation to the measured GFR across all BMI groups. Looking at the different stages of CKD, for stage 3, CKD-EPI had the highest correlation, whilst for advanced CKD, CG had the highest correlation. Of the three estimated GFR equations studied, MDRD is the most accurate, however, CKD-EPI has a smaller bias and a better precision when compared to measured GFR. When we included the influence of BMI, age and looking at the performance of each estimated GFR equations for different stages of CKD, CKD-EPI gives the best estimation of GFR with almost comparable performance of MDRD. 
596 |a 6 
655 7 |a Theses, IIUM local 
690 |a Dissertations, Academic  |x Department of Anaesthesiology and Intensive Care  |z IIUM 
700 0 |a Azrina Md Ralib,  |e degree supervisor 
700 0 |a Rozilah @ Abdul Hadi Mohamed,  |e degree supervisor 
700 0 |a Nur Fariza Ramly,  |e degree supervisor 
700 0 |a Mohamad Shahrir Abdul Rahim,  |e degree supervisor 
710 2 |a International Islamic University Malaysia.  |b Department of Anaesthesiology and Intensive Care 
856 4 |u http://studentrepo.iium.edu.my/handle/123456789/10367  |z Click here to view 1st 24 pages of the thesis. Members can view fulltext at the specified PCs in the library. 
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