Akademik Veri Yönetim Sistemi
Turkish Journal of Biochemistry, cilt.50, sa.4, ss.564-572, 2025 (SCI-Expanded)
Chronic kidney disease (CKD) is a significant health issue worldwide, leading to both cardiovascular diseases and the development of end-stage chronic kidney failure. Guidelines recommend the use of serum creatinine and glomerular filtration rate (GFR) calculations as the first step in the assessment of renal function. In this study, we aimed to assess the performance of three different creatinine-based GFR estimation formulae (Chronic Kidney Disease Epidemiology Collaboration, CKD-EPI 2021; Modification of Diet in Renal Disease, MDRD; Cockcroft-Gault, CG) by comparing them to measured GFR using technetium-99m diethylene triamine penta-Acetic acid (99mTc-DTPA) with dual plasma sampling, a more reliable method for GFR assessment. A total of 905 patients, 433 male and 472 female, who applied for routine GFR measurement with 99mTc-DTPA between 2012 and 2016 were included in this study. The median GFR value measured by 99mTc-DTPA using dual plasma sampling was 25mL/min/1.73m2, while the formulae based on creatinine overestimated GFR. Kappa analysis showed moderate levels of agreement in classifying CKD stages. The highest discrepancies were observed in patients with normal creatinine values. In older adults, serum creatinine levels and creatinine-based GFR estimation may not reliably reflect renal function due to age-related physiological changes such as decreased muscle mass and creatinine production. Nevertheless, our results suggest that the weight-corrected CG formula may be a suitable alternative to overcome these limitations in patients over 60 years of age when GFR cannot be determined by cystatin C or 99mTc-DTPA.