I Have just been estimating the effect of introducing eGFR for Burton.
According to the review article in the Annals this month the proportions
of patients in the different GFR categories is:
Quoted prevalence GFR <15 GFR 15 -<30 GFR 30-<60 GFR
60-<90
0.2% 0.2% 4.3%
3%
I have estimated the prevalence in the samples we have analysed at
Burton over the last 5 years (data attached).
Equation used:
eGFR=
186*((Creatinines!Result/88.4)^(-1.154))*(Creatinines!Age^(-0.203))*Crea
tinines![Sex modifier]*Creatinines![ethnic modifier]
This shows a range of possible prevalence for each category because
several samples may have been analysed on any individual patient in the
year. The lowest value assumes that the 'best' eGFR is the true value,
the highest assumes the 'worst' is the true value. The truth probably
lies somewhere between. The prevalences we saw in this patient
population were way above what is predicted.
Approx mid-range of
Observed prevalence GFR <15 GFR 15 -<30 GFR 30-<60
GP results 0.2% 1% 17%
General Medicine 1.0% 2.5% 18%
General surgery 0.3% 1.5% 17%
This is a lot worse than the Annals figures suggest so could have major
impacts on clinical services!
TIM
****************************************************
Prof. Tim Reynolds,
Clinical Chemistry Department,
Queens Hospital,
Belvedere Rd.,
Burton-on-Trent,
STAFFORDSHIRE,
DE13 0RB,
UK.
tel: 01283 511511 ext. 4035
fax: 01283 593064
email: [log in to unmask]
alternative email for the all too frequent occasions when the NHS email
connection doesn't work:
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> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]] On Behalf Of David Burgess
> Sent: 16 September 2005 10:40
> To: [log in to unmask]
> Subject: eGFR
>
>
> Dear Micheal,
> In Sunderland we have been asked to provide the eGFR to our renal
> patients. It seemed best to make it part of our renal
> profile and I have
> been sent the code to install it on Meditech HISS. We will
> look at doing
> this in the near future. We won't have ethnicity data and
> probably won't
> include that element in the calculation. We have some
> reservations about
> its accuracy where GFR and creatinine is close to normal. It
> places more
> responsibility on the lab to get good accuracy for creatinine
> values <100
> umol/l. I previously used the amidohydrolase slide method
> which has good
> specificity and accuracy. How good I wonder are the modified
> Jaffe methods
> at this concentration? Look forward to further discussion,
> Regards, David.
>
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