Glomerular Filtration Rate (GFR) – How to estimate with CKD-EPI, MDRD or Cockcroft-Gault

There are different formulas to estimate the GFR. The National Kidney Foundation recommends using the CKD-EPI equation, but we also will mention the MDRD equation and the Cockcroft-Gault equation.

CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)

For Black Female with SCr ≤ 0.7: GFR = 166 × (Scr/0.7)-0.329 × (0.993)Age

For Black Female with SCr > 0.7: GFR = 166 × (Scr/0.7)-1.209 × (0.993)Age

For Black Male with SCr ≤ 0.9: GFR = 163 × (Scr/0.9)-0.411 × (0.993)Age

For Black Male with SCr > 0.9: GFR = 163 × (Scr/0.9)-1.209 × (0.993)Age

For White or other Female with SCr ≤ 0.7: GFR = 144 × (Scr/0.7)-0.329 × (0.993)Age

For White or other Female with SCr > 0.7: GFR = 144 × (Scr/0.7)-1.209 × (0.993)Age

For White or other Male with SCr ≤ 0.9: GFR = 141 × (Scr/0.9)-0.411 × (0.993)Age

For White or other Male with SCr > 0.9: GFR = 141 × (Scr/0.9)-1.209 × (0.993)Age

MDRD (Modification of Diet in Renal Disease)

eGFR (mL/min/1.73 m2) = 175 × (Serum creatinine)-1.154 × (Age)-0.203 × (0.742 if female) × (1.212 if African American)

Cockcroft-Gault

Ccr/eGFR = (140 – age) x (weight in kg)/72 × Serum creatinine (in mg/dL); if female, result x 0.85.

Understanding the results:

StageGFRDescriptionTreatment
190+Normal kidney function but urine findings or structural abnormalities or genetic trait point to kidney diseaseObservation, control of risk factors and BP
260-89Mildly reduced kidney function, and other findings (as for stage 1) point to kidney diseaseObservation, control of risk factors and BP
3a45-59Moderately reduced kidney functionObservation, control of risk factors and BP
3b30-44Moderately reduced kidney functionObservation, control of risk factors and BP
415-29Severely reduced kidney functionPlanning for end stage disease, control of risk factors and BP.
5<15Very severe, or endstage kidney failure (sometimes call established renal failure)Dialysis, manage Hb, manage electrolytes

SOURCES, TOOLS AND FURTHER READING:

  1. Performance of the Modification of Diet in Renal Disease and Cockcroft-Gault Equations in the Estimation of GFR in Health and in Chronic Kidney Disease. JASN February 1, 2005 vol. 16 no. 2 459-466.
  2. Prediction of Creatinine Clearance from Serum Creatinine. Cockcroft D.W. · Gault M.H. Nephron 1976;16:31–41. 
  3. Comparison of Risk Prediction Using the CKD-EPI Equation and the MDRD Study Equation for Estimated Glomerular Filtration Rate. JAMA. 2012;307(18):1941-1951.
  4. Performance of the Cockcroft-Gault, MDRD, and New CKD-EPI Formulas in Relation to GFR, Age, and Body Size. CJASN June 2010 vol. 5 no. 6 1003-1009.
  5. Estimating Glomerular Filtration Rate (GFR)
  6. CKD Stages.
  7. MDCALC Cockcroft-Gault Calculator.
  8. Medscape Cockcroft-Gault Calculator.
  9. MDCALC MDRD Calculator.
  10. National Kidney Foundation CKD-EPI Calculator.
  11. QxMD CKD-EPI Calculator.