High chronic nephropathy detection yield in CKD subjects identified by the combination of albuminuria and estimated GFR

Gambaro, Giovanni; Bonfante, Luciana; Abaterusso, Cataldo; Gemelli, Alessandro; Ferraro, Pietro Manuel; Marchesini, Silvio; Conti, Giorgio; D’Angelo, Angela; Lupo, Antonio

doi:10.1093/ndt/gfr360

Cited by 5 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study has several strengths, including the large sample size accrued over a long time span, the possibility to analyze separately outpatient serum creatinine measurements and CKD defined at different thresholds, the implementation of recently developed eGFR equations and of the working standard definition of CKD, requiring chronic GFR reduction over time; with regard to the latter point, previous studies have shown that using a single serum creatinine measurement might have a significant impact on the definition of CKD [ 18 ]. Our study also has limitations, including the non-random sampling (individuals who elect to access the laboratory of a tertiary hospital might not represent the general adult population of the Lazio Region), lack of information on race and socio-economic status, and relatively low sensitivity especially for moderate CKD, causing a non-trivial rate of false negatives.…”

Section: Discussionmentioning

confidence: 99%

Validation of a Classification Algorithm for Chronic Kidney Disease Based on Health Information Systems

Ferraro

Agabiti²,

Angelici³

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Chronic kidney disease (CKD) is a common condition, characterized by high burden of comorbidities, mortality and costs. There is a need for developing and validating algorithm for the diagnosis of CKD based on administrative data. Methods: We validated our previously developed algorithm that used administrative data of the Lazio Region (central Italy) to define the presence of CKD on the basis of serum creatinine measurements performed between 2012 and 2015 at the Policlinico Gemelli Hospital. CKD and advanced CKD were defined according to eGFR (<60 and <30 mL/min/1.73 m2, respectively). Sensitivity, specificity, positive and negative predictive values (PPV/NPV) were computed. Results: During the time span of the study, 30,493 adult participants residing in the Lazio Region had undergone at least 2 serum creatinine measurements separated by at least 3 months. CKD and advanced CKD were present in 11.1% and 2.0% of the study population, respectively. The performance of the algorithm in the identification of CKD was high, with a sensitivity of 51.0%, specificity of 96.5%, PPV of 64.5% and NPV of 94.0%. Using advanced CKD, sensitivity was 62.9% (95% CI 59.0, 66.8), specificity 98.1%, PPV 40.4% and NPV 99.3%. Conclusion: The algorithm based on administrative data has high specificity and adequate performance for more advanced CKD; it can be used to obtain estimates of prevalence of CKD and to perform epidemiological research.

show abstract

Section: Discussionmentioning

confidence: 99%

Validation of a Classification Algorithm for Chronic Kidney Disease Based on Health Information Systems

Ferraro

Agabiti²,

Angelici³

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…The true prevalence of nephrosclerosis in the general population is unknown since there has been a general advice against biopsying CKD patients without proteinuria or haematuria. Italian studies found that hypertensive/ischaemic nephropathy posed one quarter of CKD, which gave a prevalence of 3.4% at age over 40 years [33,34]. A Japanese study used nonproteinuric CKD as a proxy for hypertensive nephrosclerosis and estimated a prevalence of 10% in women and 15% in men above the age of 40, but these diagnostic criteria were much wider than in most other studies [35].…”

Section: Discussionmentioning

confidence: 99%

Hypertensive nephrosclerosis: wider kidney biopsy indications may be needed to improve diagnostics

et al. 2020

View full text Add to dashboard Cite

show abstract

“…12 However, the combination of a lowered eGFR and microalbuminuria is a more efficient indicator of kidney damage. 13 It is likely that both parameters represent the spectrum of renal vascular malfunction from systemic endothelial dysfunction.…”

Section: Microalbuminuria and Estimated Glomerular Filtration Ratementioning

confidence: 99%

Microalbuminuria and estimated glomerular filtration rate

Veriava

2012

South African Family Practice

View full text Add to dashboard Cite

Hypertension and diabetes mellitus are the major causes of renal damage and cardiovascular events. The co-existence of these conditions further increases the risk of progressive renal disease, cardiovascular events, and mortality. Urinary excretion of albumin, even in small amounts, and a lowered glomerular filtration rate (GFR) are early markers of such a tendency. The importance of screening for microalbuminuria, and a lowered GFR in hypertensive and diabetic patients, lies in the early detection of preclinical kidney disease, and identification of individuals at increased risk of progressive renal disease, cardiovascular events, and mortality. Intensive therapy, directed at the optimal control of blood pressure, blood sugar, and cardiovascular risk factors, as well as interventions aimed at decreasing albuminuria and slowing the progression of renal disease, have demonstrable beneficial effects. © MedpharmS Afr Fam Pract 2012;54(2)(Suppl 1):S17-S19

show abstract

High chronic nephropathy detection yield in CKD subjects identified by the combination of albuminuria and estimated GFR

Cited by 5 publications

References 18 publications

Validation of a Classification Algorithm for Chronic Kidney Disease Based on Health Information Systems

Validation of a Classification Algorithm for Chronic Kidney Disease Based on Health Information Systems

Hypertensive nephrosclerosis: wider kidney biopsy indications may be needed to improve diagnostics

Microalbuminuria and estimated glomerular filtration rate

Contact Info

Product

Resources

About