An evaluation of the performance of Cockcroft–Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease–Epidemiology Collaboration equations in estimating glomerular filtration rate among at-risk adults: A community-based study
Abstract
Background: Late presentation of chronic kidney disease (CKD) remains a major challenge in sub-Saharan Africa, contributing to preventable morbidity and mortality. Early identification of reduced kidney function is essential for timely intervention. Although estimated glomerular filtration rate (eGFR) equations are widely used, their performance in community-based at-risk populations is not well established. Methods: This community-based study evaluated the performance of three eGFR equations – CKD–Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD), and Cockcroft–Gault (CG) – among at-risk adults, using creatinine clearance (CrCl) (which may overestimate true glomerular filtration rate [GFR]) as the reference standard. Key performance metrics included sensitivity, specificity, precision, negative predictive value (NPV), and P30 accuracy (proportion of estimates within ± 30% of measured GFR); metrics are interpreted as relative, given that CrCl may overestimate true GFR. CKD classification was based solely on GFR thresholds. Results: The mean age was 41.8 ± 12.7 years, and 58.5% (n = 234) were female. CKD-EPI demonstrated the best overall performance, with the highest P30 accuracy (95%; 378/400), compared with MDRD (73%; 292/400) and CG (72%; 286/400). Precision was similar across equations (16 vs. 15 vs. 15 mL/min/1.73 m2), but CKD-EPI showed higher sensitivity, better NPV, and the least bias. Conclusion: The performance of eGFR equations varies in community screening settings. CKD-EPI slightly overestimates GFR but still provides the most accurate estimates and may be preferable for the identification of impaired kidney function in at-risk populations.
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BibTeX
@article{braimoh2026evaluation,
title = {{An evaluation of the performance of Cockcroft–Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease–Epidemiology Collaboration equations in estimating glomerular filtration rate among at-risk adults: A community-based study}},
author = {Rotimi Williams Braimoh and Ale Olagoke Korede and Bello Taslim Babawale},
journal = {Journal of Clinical Sciences},
year = {2026},
month = jul,
doi = {10.4103/jcls.jcls_230_25},
url = {https://doi.org/10.4103/jcls.jcls_230_25},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - An evaluation of the performance of Cockcroft–Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease–Epidemiology Collaboration equations in estimating glomerular filtration rate among at-risk adults: A community-based study
AU - Rotimi Williams Braimoh
AU - Ale Olagoke Korede
AU - Bello Taslim Babawale
PY - 2026
DA - 2026/07/01
JO - Journal of Clinical Sciences
DO - 10.4103/jcls.jcls_230_25
UR - https://doi.org/10.4103/jcls.jcls_230_25
AB - Background: Late presentation of chronic kidney disease (CKD) remains a major challenge in sub-Saharan Africa, contributing to preventable morbidity and mortality. Early identification of reduced kidney function is essential for timely intervention. Although estimated glomerular filtration rate (eGFR) equations are widely used, their performance in community-based at-risk populations is not well established. Methods: This community-based study evaluated the performance of three eGFR equations – CKD–Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD), and Cockcroft–Gault (CG) – among at-risk adults, using creatinine clearance (CrCl) (which may overestimate true glomerular filtration rate [GFR]) as the reference standard. Key performance metrics included sensitivity, specificity, precision, negative predictive value (NPV), and P30 accuracy (proportion of estimates within ± 30% of measured GFR); metrics are interpreted as relative, given that CrCl may overestimate true GFR. CKD classification was based solely on GFR thresholds. Results: The mean age was 41.8 ± 12.7 years, and 58.5% (n = 234) were female. CKD-EPI demonstrated the best overall performance, with the highest P30 accuracy (95%; 378/400), compared with MDRD (73%; 292/400) and CG (72%; 286/400). Precision was similar across equations (16 vs. 15 vs. 15 mL/min/1.73 m2), but CKD-EPI showed higher sensitivity, better NPV, and the least bias. Conclusion: The performance of eGFR equations varies in community screening settings. CKD-EPI slightly overestimates GFR but still provides the most accurate estimates and may be preferable for the identification of impaired kidney function in at-risk populations.
SN - 2468-6859
SN - 2408-7408
ER -