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QJM Advance Access originally published online on January 14, 2008
QJM 2008 101(2):155-158; doi:10.1093/qjmed/hcm134
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

New results from the Modification of Diet in Renal Disease study: the importance of clinical outcomes in test strategies for early chronic kidney disease

P.D. Giles1, P.B. Rylance2 and D.C. Crothers1

From the 1Department of Biochemistry, Walsall Hospitals NHS Trust, Wallsall, West Midlands WS2 9PS, UK, and 2Renal Unit, New Cross Hospital, Wolverhampton, WV10 0QP (Royal Wolverhampton NHS Trust).

Address correspondence to Dr P.D. Giles, Department of Biochemistry, Walsall Hospitals NHS Trust, Moat Road, Walsall, West Midlands WS2 9PS, UK. email: Paul.giles{at}walsallhospitals.nhs.uk

Received 4 September 2007 and in revised form 17 November 2007


  Abstract

A formula derived from the Modification of Diet in Renal Disease (MDRD) study in chronic renal disease is widely used to estimate glomerular filtration rate (GFR). Recently a ten-year follow-up of MDRD participants evaluated four tests of kidney function measured at baseline as predictors of important long-term clinical outcomes.

Surprisingly, neither formula-estimated GFR nor reference method GFR showed a clear advantage over simple creatinine measurement whereas another test, cystatin C, looked more promising. This raises important points of principle in terms of how the usefulness of test strategies should be assessed. Data on clinical outcomes are an essential ingredient in this process.


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