Validation of the Lund-Malmö, Chronic Kidney Disease Epidemiology (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations to estimate glomerular filtration rate in a large Swedish clinical population.

Abstract Objective. The aim of this study was to validate externally the Swedish Lund–Malmo revised creatinine-based glomerular filtration rate (GFR) equations (LM Revised) in a Swedish cohort in comparison with the North American Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology (CKD-EPI) equations. Material and methods. The study included 1397 examinations [median age 61 years, median body mass index (BMI) 26 kg/m2] in 996 patients referred for iohexol clearance (median 44 ml/min/1.73 m2). Bias, precision [interquartile range (IQR)], accuracy expressed as percentage of estimates ± 10% (P 10) and ± 30% (P 30) of measured GFR, and classification ability for five GFR stages (<15, 15–29, 30–59, 60–89 and ≥90 ml/min/1.73 m2) were compared. Results. Overall, all three equations performed satisfactorily: LM Revised, MDRD, CKD-EPI showed, respectively, a median bias of –5.8%, –2.2% and 1.7%, IQR 11.9, 12.3 and 11.7 ml/min/1.73 m2, P 10 35%, 34% and 38%, P 30 84%, 79% and 79% a...