How to Best Define Patients with Moderate Chronic Kidney Disease

Emara, Mohamed; Zahran, Ahmed; Hady, Hassan Abd El; Shoker, Ahmed

doi:10.1159/000167866

Cited by 5 publications

(4 citation statements)

References 105 publications

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“…The Virga equation was shown to be amongst the most sensitive formulas to detect inulin GFR <60 ml/min/ 1.73 m 2 in CKD patients [26]. In our study, this equation estimated the highest GFR levels among creatinine-based equations and the lowest CKD prevalence among all equations, particularly in individuals aged ≥65 years.…”

Section: Discussionmentioning

confidence: 54%

Estimating the Glomerular Filtration Rate in the General Population Using Different Equations: Effects on Classification and Association

Pattaro

Riegler

Stifter³

et al. 2013

Nephron Clin Pract

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Background/Aims: Several formulas for glomerular filtration rate (GFR) estimation, based on serum creatinine or cystatin C, have been proposed. We assessed the impact of some of these equations on estimated GFR (eGFR) and chronic kidney disease (CKD) prevalence, and on the association with cardiovascular risk factors, in a general population sample characterized by a young mean age. Methods: We studied 1,199 individuals from three Alpine villages enrolled into the MICROS study. eGFR was obtained with the 4- and 6-parameter MDRD study equations, the Virga equation, and with the three CKD-EPI formulas for creatinine, cystatin C, and the combination of creatinine and cystatin C. We assessed the concordance between quantitative eGFR levels, CKD prevalence, and in terms of association with total, LDL, and HDL cholesterol. Results: The highest and lowest eGFR levels corresponded to the cystatin C-based and MDRD-4 equations, respectively. CKD prevalence varied from 1.8% (Virga) to 5.8% (MDRD-4). The CKD-EPI based on creatinine showed the highest agreement with all other equations. Agreement between methods was higher at lower eGFR levels, older age, and in the presence of diabetes and hypertension. Creatinine-based estimates of eGFR were associated with total and low-density lipoprotein but not high-density lipoprotein cholesterol. The opposite was observed for the cystatin C-based GFR. Conclusion: GFR estimation is strongly affected by the chosen equation. Differences are more pronounced in healthy and younger individuals. To identify CKD risk factors, the choice of the equation is of secondary importance to the choice of the biomarker used in the formula. If eGFR is not calibrated to a gold standard GFR in the general population, reports about CKD prevalence should be considered with caution.

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Section: Discussionmentioning

confidence: 54%

Estimating the Glomerular Filtration Rate in the General Population Using Different Equations: Effects on Classification and Association

Pattaro

Riegler

Stifter³

et al. 2013

Nephron Clin Pract

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“…The serum creatinine concentrations were generated from the following calibration equation: Jaffe's kinetic method SCr (mg/ dl) = 0.795×[enzymatic method SCr (mg/dL)]+0.29 [19]. The moderate chronic kidney disease (CKD) was commonly defined as eGFR <60 ml/min/1.73 m 2 [20].…”

Section: Laboratory Measurements and Definitionsmentioning

confidence: 99%

Association of Thyroid Function With the Estimated Glomerular Filtration Rate in a Large Chinese Euthyroid Population

Wang¹,

Xie

Gu³

et al. 2018

Kidney Blood Press Res

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Background/Aims: We aimed to explore whether thyroid function within a normal range is associated with the estimated glomerular filtration rate (eGFR) and the incidence of chronic kidney disease (CKD) in a large Chinese population. Methods: We conducted a cross-sectional study that included 10,859 euthyroid individuals who underwent an annual regular health checkup in Jiangsu Province Official Hospital between August 2012 and August 2013. We measured the thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels using a Roche modular analytics E170 and then calculated the eGFR using the Chinese modified Modification of Diet in Renal Disease (CMDRD) equation. Results: In multiple linear regression models, TSH was negatively associated with eGFR after adjusting for confounding factors (β = -0.072, P = 1.994×10^-22). The significance remained in both males and females. No significant association was observed between FT4 and eGFR. In the logistic regression model, we did not observe significant associations of TSH or FT3 with CKD. Participants in the highest quartile of FT4 versus the lowest quartile (reference) had an increased risk of CKD (OR = 1.763, P = 0.012). The risk of CKD was more pronounced in females with the highest quartile of FT4 (OR = 2.424, P = 0.029). Conclusion: Our findings suggest that TSH is associated with eGFR in euthyroid individuals and that higher FT4 is associated with an increased risk of CKD. More cohort studies are warranted to confirm whether the association is causal.

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“…However, none of these two equations is optimal for all GFR ranges, patient subgroups, different nationalities and ethnicities [5][6][7][8][9][10][11][12][13]. Validation results may also be influenced by the chosen reference GFR measurement method [14,15] and by the calibration of the creatinine assay as well as type of creatinine assay method [16].…”

Section: Introductionmentioning

confidence: 99%

The revised Lund-Malmö GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population

Nyman

Grubb

Larsson

et al. 2014

Clinical Chemistry and Laboratory Medicine (CCLM)

168

147

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The revised Lund-Malmo GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish populationNyman, Ulf; Grubb, Anders; Larsson, Anders; Hansson, Lars-Olof; Flodin, Mats; Nordin, Gunnar; Lindstrom, Veronica; Björk, Jonas General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Results:The overall results of LM Revised/MDRD/ CKD-EPI were: median bias 2%/8%/11%, IQR 12/14/14 mL/min/1.73 m 2 , P 10 40%/35%/35% and P 30 84%/75%/76%. LM Revised was the most stable equation in terms of bias, precision and accuracy across mGFR, age and BMI intervals irrespective of gender. MDRD and CKD-EPI overestimated mGFR in patients with decreased kidney function, young adults and elderly. All three equations overestimated mGFR and had low accuracy in patients with BMI < 20 kg/m 2 , most pronounced among men. Conclusions: In settings similar to the investigated cohort LM Revised should be preferred to MDRD and CKD-EPI due to its higher accuracy and more stable performance across GFR, age and BMI intervals.

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How to Best Define Patients with Moderate Chronic Kidney Disease

Cited by 5 publications

References 105 publications

Estimating the Glomerular Filtration Rate in the General Population Using Different Equations: Effects on Classification and Association

Estimating the Glomerular Filtration Rate in the General Population Using Different Equations: Effects on Classification and Association

Association of Thyroid Function With the Estimated Glomerular Filtration Rate in a Large Chinese Euthyroid Population

The revised Lund-Malmö GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population

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