Performance of three glomerular filtration rate estimation equations in a population of sub‐Saharan Africans with Type 2 diabetes

Agoons, Dayawa D.; Balti, Eric Vounsia; Kaze, F.; Azabji-Kenfack, Marcel; Ashuntantang, Gloria; Kengne, André Pascal; Sobngwi, Eugène; Mbanya, Jean Claude

doi:10.1111/dme.12996

Cited by 14 publications

(10 citation statements)

References 27 publications

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“… 46 N/L ratio, which combines the predictive power of both increased neutrophil count and decreased lymphocyte count, 47 was associated with reduced eGFR in our study, as also found in other studies. 23 48 49 Indeed previous studies, which included patients with CKD on haemodialysis 23 48 and predialysis, 49 showed that an increased N/L ratio was associated with known inflammatory markers such as tumour necrosis factor-α, 23 interleukin 6 and hsCRP levels. 49 These studies demonstrated that these well-established markers of inflammation were independent factors for predicting N/L ratio, thus presenting N/L ratio as an inflammatory biomarker for patients with CKD.…”

Section: Discussionmentioning

confidence: 96%

Haematological profile of chronic kidney disease in a mixed-ancestry South African population: a cross-sectional study

et al. 2018

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ObjectivesThe objectives were to characterise the haematological profile of screen-detected chronic kidney disease (CKD) participants and to correlate the complete blood count measures with the commonly advocated kidney function estimators.MethodsThe current cross-sectional study used data, collected between February 2015 and November 2016, of 1564 adults of mixed-ancestry, who participated in the Cape Town Vascular and Metabolic Health study. Kidney function was estimated using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and anaemia as haemoglobin level <13.5 g/dL (men) and <12 g/dL (women).ResultsBased on the MDRD and CKD-EPI equations, the crude prevalence of CKD was 6% and 3%. Irrespective of the equation used, median red blood cell (RBC) indices were consistently lower in those with CKD compared with those without CKD (all p<0.0001). Despite not showing any significant difference in total white blood cell (WBC) count between the two groups, the number of lymphocytes were lower (p=0.0001 and p<0.0001 for MDRD and CKD-EPI, respectively) and neutrophil count (both p<0.0297) and the ratio of lymphocytes to neutrophil (both p<0.0001) higher in the CKD group compared with those without CKD; with the remaining WBC indices similar in the two groups. The platelet count was similar in both groups. Of the screen-detected CKD participants, 45.5% (MDRD) and 57.8% (CKD-EPI) were anaemic, with the prevalence increasing with increasing severity of CKD, from 37.2% (stage 3) to 82.4% (stages 4–5). Furthermore, CKD-EPI-estimated kidney function, but not MDRD, was positively associated with RBC indices.ConclusionThough it remains unclear whether common kidney function estimators provide accurate estimates of CKD in Africans, the correlation of their estimates with deteriorating RBC profile, suggests that advocated estimators, to some extent approximate kidney function in African populations.

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Section: Discussionmentioning

confidence: 96%

Haematological profile of chronic kidney disease in a mixed-ancestry South African population: a cross-sectional study

et al. 2018

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“…Given that results from studies evaluating the performance of estimated GFR (eGFR) equations in black Africans have been inconsistent ( 20 , 21 ), we calculated race and gender-specific eGFR using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. A recent evaluation of eGFR equations among Africans with T2D showed that the MDRD was associated with lower bias compared to the CKD-EPI and Cockcroft–Gault equations ( 22 ). Thus, we used eGFR calculated from the MDRD equation for our multivariate analyses.…”

Section: Methodsmentioning

confidence: 99%

Impact of Type 2 Diabetes on Impaired Kidney Function in Sub-Saharan African Populations

et al. 2016

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BackgroundDiabetes is a leading risk factor for impaired kidney function, an indicator of chronic kidney disease. The aim of this study was to examine the association between type 2 diabetes (T2D) and impaired kidney function among adults in sub-Saharan Africa (SSA).MethodsParticipants were enrolled from Ghana, Kenya, and Nigeria. Impaired kidney function was based on an estimated glomerular filtration rate <60 ml/min/1.73 m2. Using logistic regression models, we conducted case–control analyses to estimate the multivariate-adjusted association of T2D and kidney function.ResultsWe used data from 4815 participants for whom the mean (SD) age was 48 (15) years, 41% were male and 46% had T2D. Those with T2D were more likely to have impaired kidney function [13.4% (95% CI: 11.9–14.7)] compared to those without T2D [4.8% (95% CI: 4.0–5.6)], p-value <0.001. The multivariate odds ratio of impaired kidney function among those with type 2 diabetes was 1.50 (95% CI: 1.17–1.91) p-value = 0.001, compared to those without T2D. Also, individuals with T2D who were at least 60 years old, obese, hypertensive or dyslipidemic were more likely to have impaired kidney function compared to those without T2D.ConclusionT2D was associated with 50% increased risk of impaired kidney function in this sample of adults from SSA. Interventions targeted at prevention, early diagnosis, and management of T2D are likely to reduce the burden of kidney disease in SSA.

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“…Regarding the relative superiority of MDRD to the CG formula for detecting various stages of AKI early after kidney donation, other researchers have shown the advantage of MDRD over both the CG formula and the Chronic Kidney Disease Epidemiology Collaboration equation for estimating GFR and diagnosing impaired renal function. 11 Owing to the nonlinear relation between creatinine/cystatin C and GFR, 4 relatively small initial incremental increases in these markers correlate with significant decreases in GFR. This nonlinearity is more pronounced when using kinetic GFR as a measure, as reflected by the greater percentile reduction in kinetic GFR compared with CG and MDRD GFR formulas on day 1 after donation ( Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Untitled

Hekmat

Eshraghi²,

Esmailpour³

et al. 2017

Exp Clin Transplant

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Objectives: Kinetic glomerular filtration rate estimation may have more power and versatility than the Modification of Diet in Renal Disease or CockcroftGault formula for evaluating kidney function when plasma creatinine fluctuates rapidly. After kidney donation, glomerular filtration rate rapidly fluctuates in otherwise healthy patients. We compared 3 formulas for estimating glomerular filtration rate: kinetic, Modification of Diet in Renal Disease, and Cockcroft-Gault, for determining stages of acute kidney injury early after kidney donation. Materials and Methods: In 42 living kidney donors, we measured serum creatinine, cystatin C, neutrophil gelatinase-associated lipocalin, and glomerular filtration rates before uninephrectomy and 3 days afterward. To estimate glomerular filtration rate, we used Cockcroft-Gault, Modification of Diet in Renal Disease, and kinetic equations. We sought the most accurate formula for staging acute kidney injury according to the risk, injury, failure, loss, and end-stage criteria. Results: The kinetic glomerular filtration rate model found more cases of stage 3 acute kidney injury than did the Modification of Diet in Renal Disease or Cockcroft-Gault formula. Receiver operating characteristic curves showed that the kinetic glomerular filtration rate model had more sensitivity and specificity than the Cockroft-Gault formula for discriminating among risk, injury, failure, loss, and end-stage criteria stages of acute kidney injury, based on serum creatinine changes. On day 2 after donation, a more sensitive marker with a shorter half-life (serum neutrophil gelatinase-associated lipocalin) was more significantly correlated with kinetic glomerular filtration rate estimation. Conclusions: The kinetic glomerular filtration rate model was able to discriminate stages of acute kidney injury early after kidney donation according to risk, injury, failure, loss, and end-stage criteria better than the Modification of Diet in Renal Disease or CockcroftGault formulas. The kinetic model detected failurestage acute kidney injury ≥ 1 to 2 days earlier than the MDRD formula, CG formula detected no failure.

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Performance of three glomerular filtration rate estimation equations in a population of sub‐Saharan Africans with Type 2 diabetes

Cited by 14 publications

References 27 publications

Haematological profile of chronic kidney disease in a mixed-ancestry South African population: a cross-sectional study

Haematological profile of chronic kidney disease in a mixed-ancestry South African population: a cross-sectional study

Impact of Type 2 Diabetes on Impaired Kidney Function in Sub-Saharan African Populations

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