Learn about the
2008T Fresenius Hemodialysis

Interview with
Jeffrey H. Burbank
Founder& CEO of NxStage

Publication:

Estimated Glomerular Filtration Rate and Prognosis in Heart Failure: Value of the Modification of Diet in Renal Disease Study-4, Chronic Kidney Disease Epidemiology Collaboration, and Cockroft-Gault Formulas

J Am Coll Cardiol 2012 59: 1709-1715
Zamora, Elisabet, Lupon, Josep, Vila, Joan, Urrutia, Agustin, de Antonio, Marta, Sanz, Hector,
Grau, Maria, Ara, Jordi, Bayes-Genis, Antoni

Unitat d'Insuficiència Cardíaca, Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
 Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain

What are the main findings of the study?

In an ambulatory real-life cohort of heart failure patients, the Cockroft-Gault formula was the most accurate of the 3 most used eGFR formulas to improve the risk stratification for death.

The improvement in risk assessment remained strong when it was estimated by means of statistical measures that evaluate model prediction, discrimination, and calibration.

Were any of the findings unexpected?

The MDRD-4 formula is the most used eGFR formula and in different settings has been shown to be more accurate than the older Cockroft-Gault formula.

Also the most recent CKD-EPI has been suggested to be even more precise than the MDRD in general population.

However, in the chronic heart failure setting and in the risk stratification for death the “older” Cockroft-Gault formula was the most accurate to predict death.

What should clinicians and patients take away from this study?

The Cockroft-Gault formula is not outdated or obsolete and in ambulatory patients with HF performs better for predicting death than the MDRD-4 formula or CKD-EPI equation.

What recommendations do you have for future studies as a result of your study?

It seems advisable to use Cockroft-Gault formula for estimating risk of death in ambulatory patients with heart failure.