Am J Perinatol 2007; 24(10): 569-574
DOI: 10.1055/s-2007-986697
© Thieme Medical Publishers

Estimation of Glomerular Filtration Rate in Preeclamptic Patients

Arnold B. Alper1 , Yeonjoo Yi3 , Larry S. Webber3 , Gabriella Pridjian2 , Abimbola Aina Mumuney4 , George Saade5 , Jamie Morgan5 , Bahij Nuwayhid6 , Michael Belfort7 , Jules Puschett1
  • 1Department of Medicine (Section of Nephrology), Tulane University Medical Center, New Orleans, Louisiana
  • 2Department of Obstetrics and Gynecology, Tulane University Medical Center, New Orleans, Louisiana
  • 3Department of Biostatistics, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
  • 4Department of Obstetrics and Gynecology, Johns Hopkins School of Medicine, Baltimore, Maryland
  • 5Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
  • 6Department of Obstetrics and Gynecology, the Texas Tech-El Paso School of Medicine, El Paso, Texas
  • 7Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah
Further Information

Publication History

Publication Date:
01 October 2007 (online)

ABSTRACT

Accurate estimation of the glomerular filtration rate (GFR) in patients with preeclampsia is often difficult or impossible to accomplish. In this study, the Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and MDRD2 formulas were evaluated for their accuracy in determining GFR in the setting of preeclampsia. The estimated GFR calculated from these formulas was compared with the creatinine clearance values obtained from a 24-hour urine collection in 209 preeclamptic patients recruited from five large hospitals. Additionally, a set of new equations that more accurately estimate GFR in preeclamptic patients based on ethnicity, preeclampsia GFR (PGFR), was created. Both the CG and MDRD formulas were inaccurate in predicting GFR in preeclamptic patients, and both were significantly less accurate than PGFR. In conclusion, current GFR estimation equations based on serum creatinine values in nonpregnant patients are not reliable measures of renal function in patients with preeclampsia. The use of a new (PGFR) formula is recommended.

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Jules PuckettM.D. 

Texas A & M Health Science Center, College of Medicine/Scott & White

Medical Education Building 407 L, 2401 South 31st Street, Temple, TX 76508

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