A 37 year old man attended his GP\'s office for a routine pre-employment physica

Question

A 37 year old man attended his GP's office for a routine pre-employment physical following a long period working as a bookkeeper from home. He is Caucasian and on examination appeared in relatively good health, though reported an increase in snoring which was disrupting his sleep. His BMI was 29.4 (92kg) and blood pressure was 130/85. The following biochemistry results were obtained Plasma Urine Result 140 mmol/L 133-143 3.8 mmol/L 3.6-4.6 25 mmol/L 24-32 105 mmol/L 98-108 5.2 mmol/L 3.0-7.0 40 mmis.60-120 Reference Range Result Reference Negativ Negativ Range Na Dipstick Protein Blood Albumin/Creatinin 0.010g

Explanation / Answer

According to cockcroft - gault formula creatinine clearance rate is equal to GFR

Creatinine clearance rate = (140-age) x (weight in kg) / (72x serum creatinine)

Here serum creatinine = 200umol/L or 200 x 0.0113 = 2.26 mg/dl , age is 39 ( as data is collected again after 2 years) , weight is 102

Creatinine clearance rate = 63.24ml/l

According to cockcroft gault formula GFR between 60-89 show 2nd stage kidney disease.

MDRD formula is GFR (mL/min/1.73 m²) = 175 × (Scr)-1.154 × (Age)-0.203 × (0.742 if female) × (1.212 if African American)

GFR = 32ml/ min/1.74 m2.

According to MDRD formula GFR below 60ml/ min/ 1.73m2 show chronic kodney disease.

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