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Instructions
The MDRD equation estimates the glomerular filtration rate (eGFR), a measure of kidney function that is more accurate than creatinine clearance in many patients. It requires the patient’s serum creatinine, age, sex, and race (Black or non-Black in the original equation). Clinicians should use the most recent laboratory results when applying the equation. MDRD is primarily intended for staging chronic kidney disease (CKD), not for adjusting drug doses. The equation is most reliable when eGFR is below 60 mL/min/1.73 m² and less accurate in higher ranges.
Overview
When to use
Why use
Evidences
Interpretation
GFR = 175 × Serum Creatinine(in mg/dL)-1.154× age-0.203 × 1.212 (if patient is black*) × 0.742 (if female)
The Modification of Diet in Renal Disease (MDRD) Study created equations to estimate GFR from serum creatinine, age, sex, and race; the widely used 4‑variable MDRD equation was later “re‑expressed” for standardized, IDMS‑traceable creatinine assays to improve accuracy and allow clinical laboratories to report eGFR routinely.
https://pubmed.ncbi.nlm.nih.gov/17332152/
Professional summaries note the MDRD 1999 equation (and its 2006 re‑expressed version) became the first broadly adopted creatinine‑based eGFR, recommended historically by KDOQI, and built on data from 1628 CKD patients
Systematic reviews comparing MDRD with CKD‑EPI show CKD‑EPI generally has lower bias and higher accuracy, particularly when true GFR is ≥60; a meta‑analysis found CKD‑EPI accuracy (P30) about 2.7% higher than MDRD overall, with greater advantage at higher GFR ranges
https://pmc.ncbi.nlm.nih.gov/articles/PMC9632528/
A targeted review of special populations concluded MDRD lacked validity (bias ≤20%, precision ≤30%, P30 ≥80%) in several groups with renal impairment, including diabetes, liver cirrhosis, hospitalized patients, and older adults, underscoring population-specific limitations for dosing or staging decisions
Overview
When to use
Why use
Evidences
The Modification of Diet in Renal Disease (MDRD) Study equation is one of the most widely used tools for estimating kidney function. Developed in the late 1990s from data in patients with CKD, it calculates the estimated glomerular filtration rate (eGFR), an essential measure of renal function. The formula incorporates serum creatinine, age, sex, and race, producing a value normalized to body surface area (mL/min/1.73 m²). Unlike the Cockcroft-Gault equation, MDRD does not require weight, making it convenient for standardized reporting.
The MDRD equation is most useful for identifying and staging chronic kidney disease. It is currently recommended by many laboratories worldwide, which automatically report eGFR alongside serum creatinine results. It helps clinicians classify CKD into stages, monitor progression, and make timely referrals to nephrology. MDRD was instrumental in standardizing CKD definitions and enabling earlier detection of kidney disease.
However, the MDRD equation has limitations. It systematically underestimates kidney function in individuals with near-normal or mildly impaired renal function (eGFR >60 mL/min/1.73 m²), limiting its utility in screening healthy populations. Additionally, the inclusion of race adjustment has become controversial, as it may contribute to disparities in care. Some laboratories have moved to race-neutral MDRD or replaced it with the more accurate CKD-EPI equation.
Overview
When to use
Why use
Evidences
Interpretation
GFR = 175 × Serum Creatinine(in mg/dL)-1.154× age-0.203 × 1.212 (if patient is black*) × 0.742 (if female)
The Modification of Diet in Renal Disease (MDRD) Study created equations to estimate GFR from serum creatinine, age, sex, and race; the widely used 4‑variable MDRD equation was later “re‑expressed” for standardized, IDMS‑traceable creatinine assays to improve accuracy and allow clinical laboratories to report eGFR routinely.
https://pubmed.ncbi.nlm.nih.gov/17332152/
Professional summaries note the MDRD 1999 equation (and its 2006 re‑expressed version) became the first broadly adopted creatinine‑based eGFR, recommended historically by KDOQI, and built on data from 1628 CKD patients
Systematic reviews comparing MDRD with CKD‑EPI show CKD‑EPI generally has lower bias and higher accuracy, particularly when true GFR is ≥60; a meta‑analysis found CKD‑EPI accuracy (P30) about 2.7% higher than MDRD overall, with greater advantage at higher GFR ranges
https://pmc.ncbi.nlm.nih.gov/articles/PMC9632528/
A targeted review of special populations concluded MDRD lacked validity (bias ≤20%, precision ≤30%, P30 ≥80%) in several groups with renal impairment, including diabetes, liver cirrhosis, hospitalized patients, and older adults, underscoring population-specific limitations for dosing or staging decisions
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