Estimating Glomerular Filtration Rate in Asian Patients with Chronic Kidney Diseases from Bioelectrical Impedance Analysis
Bancha Satirapoj MD*, Ouppatham Supasyndh MD**, Jayanton Patumanond MD, MPH, DSc***, Punbuppa Choovichian MD**
Affiliation : * Division of Nephrology, Department of Medicine, Nopparat Rajathanee Hospital ** Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine *** Clinical Epidemiology and Medical Statistics Unit, Faculty of Medicine, Chiang Mai University
Background : Estimation of glomerular filtration rate (GFR) is usually determined from 24-hour urine collec-
tion, but it is time-consuming, and difficult in clinical practice. The authors attempted to select an accurate
and safe, but more convenient test to obtain an estimated GFR.
Objective : To compare estimation of GFR by Bioelectrical impedance analysis (BIA) with GFR calculated by
24-hour urine averaged creatinine clearance and urea clearance (Ccr-Cu-GFR).
Materials and Methods : The authors examined 79 non-diabetic chronic kidney disease (CKD) patients that
had estimated GFR between 15 and 89 ml/min/1.73 m2. Subjects were categorized into three subgroups
according to K/DOQI-CKD classification: GFR of 60-89 ml/min/1.73m2 (stage 2, 5 subjects), 30-59 ml/min/
1.73m2 (stage 3, 31 subjects), and 15-29 ml/min/1.73m2 (stage 4, 43 subjects).
Results : The mean value of Ccr-Cu-GFR was 33.79 + 14.78 ml/min/1.73 m2 and GFR by BIA (BIA-GFR), 34.63
+ 14.86 ml/min/1.73 m2 with no overall statistical differences (p = 0.838). In stage 3 CKD patients, the mean
BIA-GFR and Ccr-Cu-GFR were similar (38.84 + 12.47 vs 41.16 + 9.17, p = 0.399) while in stage 2 CKD, BIA-
GFR tended to underestimate (63.50 + 19.35 vs 70.94 + 7.82, p = 0.407) and in stage 4 CKD, BIA-GFR
significantly overestimated Ccr-Cu-GFR (27.31 + 9.11 vs 23.76 + 5.68, p = 0.040).
Conclusion : The findings suggest that BIA-GFR in non-diabetic CKD patients closely resembled with Ccr-Cu-
GFR especially in stage 3 CKD patients. BIA-GFR may be considered as a more convenient test for an
assessment of GFR in non-diabetic CKD patients.
Keywords : Glomerular filtration rate (GFR), Bioelectrical impedance analysis (BIA), Chronic kidney disease (CKD)
