MDRD GFR Equation
Modification of Diet in Renal Disease (MDRD) 4-variable equation for estimating GFR. Largely superseded by CKD-EPI but still widely reported by laboratories.
Score interpretation
eGFR ≥ 90 mL/min/1.73m²: Normal or high kidney function (if structural/marker evidence of CKD).
→ Monitor annually if CKD markers present. Optimise cardiovascular risk factors.
eGFR 60–89: Mildly decreased. Only CKD if other markers present.
→ Annual monitoring. BP control (target <130/80 in CKD). ACEi/ARB if proteinuria.
eGFR 45–59: Mildly to moderately decreased.
→ 6-monthly monitoring. Review nephrotoxic drugs. Anaemia screen (FBC, ferritin, B12, folate). PTH, phosphate.
eGFR 30–44: Moderately to severely decreased.
→ Nephrology referral if declining. Manage anaemia (ESA), bone disease (phosphate binders). Avoid NSAIDs/contrast/nephrotoxins.
eGFR 15–29: Severely decreased. Pre-dialysis planning.
→ Nephrology review. RRT planning (dialysis, transplant). AV fistula creation. Dietitian input. Immunisations (hepatitis B, pneumococcal).
eGFR < 15: Kidney failure.
→ Urgent nephrology. RRT initiation if symptomatic. Conservative pathway if elected. Emergency dialysis if hyperkalaemia/fluid overload/uraemia.
Interpretation bands for the MDRD GFR. Apply clinical judgement and local guidance.
References
- Levey AS, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med. 1999;130(6):461–470.
Related
Curated clinical cross-links plus same-class fallbacks.
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cetuximab (Specialist drug) · Anti-EGFR monoclonal antibody
- Gefitinib (Specialist drug) · EGFR tyrosine-kinase inhibitor
- Lapatinib (Specialist drug) · HER2/EGFR tyrosine-kinase inhibitor
- Lazertinib (Specialist drug) · 3rd-generation EGFR tyrosine-kinase inhibitor
- Osimertinib (Specialist drug) · 3rd-generation EGFR tyrosine-kinase inhibitor
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019
Featured in these MRCEM clinical pathways
The MDRD GFR is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.