Performance of the CKD Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) Study Equations in Healthy South Brazilians

Soares, Ariana Aguiar; Eyff, Tatiana Falcão; Campani, Raquel Barth; Ritter, Luciana; Weinert, Letícia Schwerz; Camargo, Joíza Lins; Silveiro, Sandra Pinho

doi:10.1053/j.ajkd.2010.03.008

Cited by 28 publications

(22 citation statements)

References 8 publications

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“…The results obtained using the MDRD equation confirm findings by multiple previous studies, because it has previously been observed that the MDRD equation significantly underestimates GFR among individuals with normal kidney function (1)(2)(3)(4)(5). A recent study in 96 healthy adults also found less underestimation of GFR with the CKD-EPI than the MDRD equation (18). Although including low-risk individuals in the cohort used to develop the CKD-EPI equation did attenuate underestimation of GFR in low-risk populations and improve specificity for detecting an mGFR Ͻ60 ml/min per 1.73 m 2 as compared with the MDRD equation, it did so at the expense of overestimating GFR when used in CKD patients and transplant recipients and reduced sensitivity for detecting an mGFR Ͻ60 ml/min per 1.73 m 2 .…”

Section: Discussionsupporting

confidence: 88%

Relative Performance of the MDRD and CKD-EPI Equations for Estimating Glomerular Filtration Rate among Patients with Varied Clinical Presentations

Murata¹,

Baumann²,

Saenger³

et al. 2011

Clinical Journal of the American Society of Nephrology

149

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SummaryBackground The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was developed using both CKD and non-CKD patients to potentially replace the Modification of Diet in Renal Disease (MDRD) equation that was derived with only CKD patients. The objective of our study was to compare the accuracy of the MDRD and CKD-EPI equations for estimating GFR in a large group of patients having GFR measurements for diverse clinical indications.Design, setting, participants, and measurements A cross-sectional study was conducted of patients who underwent renal function assessment for clinical purposes by simultaneous measurements of serum creatinine and estimation of GFR using the MDRD and CKD-EPI equations and renal clearance of iothalamate (n ϭ 5238).Results Bias compared with measured GFR (mGFR) varied for each equation depending on clinical presentation. The CKD-EPI equation demonstrated less bias than the MDRD equation in potential kidney donors (Ϫ8% versus Ϫ18%) and postnephrectomy donors (Ϫ7% versus Ϫ15%). However, the CKD-EPI equation was slightly more biased than the MDRD equation in native CKD patients (6% versus 3%), kidney recipients (8% versus 1%), and other organ recipients (9% versus 3%). Among potential kidney donors, the CKD-EPI equation had higher specificity than the MDRD equation for detecting an mGFR Ͻ60 ml/min per 1.73 m 2 (98% versus 94%) but lower sensitivity (50% versus 70%).Conclusions Clinical presentation influences the estimation of GFR from serum creatinine, and neither the CKD-EPI nor MDRD equation account for this. Use of the CKD-EPI equation misclassifies fewer low-risk patients as having reduced mGFR, although it is also less sensitive for detecting mGFR below specific threshold values used to define CKD stages.

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Section: Discussionsupporting

confidence: 88%

Relative Performance of the MDRD and CKD-EPI Equations for Estimating Glomerular Filtration Rate among Patients with Varied Clinical Presentations

Murata¹,

Baumann²,

Saenger³

et al. 2011

Clinical Journal of the American Society of Nephrology

149

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“…A subset of the diabetic patients [18] and the healthy volunteers [21] were previously examined in separated cohorts.…”

Section: Methodsmentioning

confidence: 99%

Performance of CKD-EPI equation to estimate glomerular filtration rate as compared to MDRD equation in South Brazilian individuals in each stage of renal function

Veronese

Gomes

Chanan

et al. 2014

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Although not clearly validated to HIV-infected individuals, equations adjusting for muscle mass, age, weight, ethnicity and sex, provide a more sensitive estimation of the true renal function, and have been used in general population (eGFR)[11], [12]. Currently, the most common formulas to estimate the GFR are Modification of Diet in Renal Disease formula (MDRD) [13], [14], Cockcroft-Galt (CG) [14], [15] and Chronic Kidney Disease Epidemiology Collaboration (CKD-epi) [16].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Risk Factors Associated to Chronic Kidney Disease in HIV-Infected Patients on HAART and Undetectable Viral Load in Brazil

et al. 2011

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BackgroundTo determine the prevalence and associated factors with chronic kidney disease (CKD) in a cohort of HIV-positive individuals with undetectable viral load on HAART.MethodsFrom March, 2009 to September 2009, 213 individuals between 18-70 years, period on HAART ≥12 months, viral load < 50 copies/mm3, and CD4 ≥ 200 cells/mm3, were consecutively enrolled at the outpatient clinic of Hospital de Clínicas, Porto Alegre, Brazil. Exclusion criteria were obesity, malnourishment, amputee, paraplegic, previous history of renal disease, pregnancy and hepatic insufficiency. Renal function was determined by estimated glomerular filtration rate (eGFR) assessed by the modification of diet in renal disease. CKD was defined as an eGFR less or equal than 60 ml/min/1.73 m2, for a period of at least 3 months. Poisson regression was used to determine factors associated with CKD.ResultsCKD was diagnosed in 8.4% of the population, and after adjustment, the risk factors were hypertension (RR = 3.88, 95%CI, 1.84 - 8.16), time on HAART (RR = 1.15, 95%CI,1.03–1.27) and tenofovir exposure (RR = 2.25, 95%CI, 1.04–4.95). Higher weight (RR = ,0.88 95%CI, 0.82–0.96) was associated to normal function.ConclusionsCKD was a common finding in this cohort of patients and was related to hypertension, time on HAART and tenofovir exposure. We suggest a more frequent monitoring of renal function, especially for those with risk factors to early identify renal impairment.

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Performance of the CKD Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) Study Equations in Healthy South Brazilians

Cited by 28 publications

References 8 publications

Relative Performance of the MDRD and CKD-EPI Equations for Estimating Glomerular Filtration Rate among Patients with Varied Clinical Presentations

Relative Performance of the MDRD and CKD-EPI Equations for Estimating Glomerular Filtration Rate among Patients with Varied Clinical Presentations

Performance of CKD-EPI equation to estimate glomerular filtration rate as compared to MDRD equation in South Brazilian individuals in each stage of renal function

Prevalence and Risk Factors Associated to Chronic Kidney Disease in HIV-Infected Patients on HAART and Undetectable Viral Load in Brazil

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