The Error of Estimated GFR in Type 2 Diabetes Mellitus

Luis-Lima, Sergio; Linares, Tomás Higueras; Henríquez-Gómez, Laura; Alonso-Pescoso, Raquel; Jiménez, Ángeles Pérez; López-Hijazo, Asunción; Negrín-Mena, Natalia; Martín, Candelaria; Sánchez-Gallego, Macarena; Galindo-Hernández, Sara Judith; Castillo, Raquel Socas Fernández del; Castilla-Marrero, Manuel; Domínguez-Coello, Santiago; León, Vanesa Vilchez de; Valcárcel-Lopez, Rafael; Insausti-Garmendia, Nerea; Eugenia, Beatríz; Estupiñán, Sara; Delgado-Mallén, Patricia; Armas-Padrón, Ana-María; Marrero-Miranda, Domingo; González-Rinne, Ana; Rodríguez, Rosa María Miquel; Cobo-Caso, María Angeles; Díaz-Martín, Laura; González‐Rinne, Federico; González-Delgado, Alejandra; López-Martínez, Marina; Sosa, Alejandro Jiménez; Torres, Armando

doi:10.3390/jcm8101543

Cited by 15 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Secondly, this is an observational study carried out in a single district hospital and thus the results cannot be generalized to patients in other settings. Finally, the error of eGFR when utilizing the CKD-EPI equation demonstrated a wide dispersion with an average of 30% [31]. This might lead to large variations in declining eGFR.…”

Section: Discussionmentioning

confidence: 95%

Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study

Le²,

Tran³

et al. 2021

Healthcare

View full text Add to dashboard Cite

This study investigated the association between serum uric acid (SUA) levels with rapid decline of the estimated glomerular filtration rate (eGFR) in type 2 diabetes (T2 DM) patients. A prospective cohort study was conducted in a community-based hospital in Vietnam. We followed 405 T2DM patients with normal kidney function for five years. Rapid progression of kidney function was defined as an average annual decrease of eGFR of at least 4 mL/min/1.73 m2 and was found in 16.0% of patients. Patients in the SUA high tertile ( ≥6 mg/dL) had higher BMI (p = 0.004), lower HbA1c (p = 0.001), lower eGFR (p < 0.001) and higher rate of hypertension than low and middle tertile. After adjusting for age and sex, rapid progression of renal function was significantly associated with SUA level (OR = 1.22, 95% CI 1.02–1.45, p = 0.026). This association was marginally significant when more covariates were included in the model (OR = 1.20, 95% CI 0.99–1.46, p = 0.065). However, the association between tertiles of SUA and rapid decline of eGFR was not statistically significant. This study demonstrates neither a strong significant association between SUA and rapid decline of eGFR nor evidence to refuse the role of SUA levels in the increased risk of renal function decline in in T2DM patients.

show abstract

Section: Discussionmentioning

confidence: 95%

Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study

Le²,

Tran³

et al. 2021

Healthcare

View full text Add to dashboard Cite

show abstract

“…For agreement analyses, we used a software (AGP Agreement Program v1.0 IGEKO, SP) available at: www. ecihucan.es/lfr/apps/?dir=agreement_installer [22]. All tests were two-sided and P < 0.050 was considered statistically significant.…”

Section: Statistical Analysesmentioning

confidence: 99%

A novel nomogram to predict the reliability of estimated glomerular filtration rate formulae in oncology patients

et al. 2020

View full text Add to dashboard Cite

Background: Formulae of estimated glomerular filtration rate (eGFR) based on serum creatinine (Scr) are routinely used in oncology patients, however, they are inaccurate in some populations. Our aim was to assess the agreement of eGFR formulae and thereby build a nomogram to predict the reliability of estimates. Methods: Measured GFR (mGFR) using isotope from 445 oncology patients were compared with eGFR from six formulae (Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD), modified MDRD formulae for Chinese (C-MDRD), Chronic Kidney Disease Epidemiology (CKD-EPI) Collaboration, Wright and full age spectrum (FAS)). Bias, precision and accuracy of eGFR formulae were examined. We also evaluated statistics of agreement: the total deviation index (TDI), the concordance correlation coefficient (CCC) and the coverage probability (CP). Multivariate logistic regression was applied to identify characteristics associated with inaccurate eGFR and construct a predictive nomogram. Results: All eGFR formulae tended to overestimate the eGFR. The percentage of patients with eGFR within 30% the mGFR ranged from 38.0 to 62.8%. Cockcroft-Gault and MDRD showed low bias and high precision. The MDRD formula exhibited lowest TDI, meaning that 90% of estimations ranged from − 36 to 36% of mGFR. Multivariate logistic regression showed that inaccuracy of MDRD was found in elderly patients or in patients with eGFR greater than 120 ml/min. A nomogram was constructed to help oncologists to predict the risk of inaccuracy of eGFR. The calibration curve showed good agreement. Conclusions: Our results suggest that the error of eGFR by any formulae was common and wide in Chinese oncology patients. Our nomogram may assist oncologists in decision-making when mGFR is needed.

show abstract

“…Bland-Altman plots were also used to assess the agreement between eGFR and the reference mGFR. We conducted all analyses using the statistical package Agreement Program (AGP v1.0, IGEKO, SP) [25] which is based on the R code developed by Lin et al [24] and available at www.ecihucan. es/lfr/apps/?dir=agreement_installer.…”

Section: Plos Onementioning

confidence: 99%

The failure of glomerular filtration rate estimating equations among obese population

Kittiskulnam

Tiskajornsiri²,

Katavetin

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

Background Obesity is a major public health with increasing numbers of obese individuals are at risk for kidney disease. However, the validity of serum creatinine-based glomerular filtration rate (GFR) estimating equations in obese population is yet to be determined. Methods We evaluated the performance of the reexpressed Modification of Diet in Renal Disease (MDRD), reexpressed MDRD with Thai racial factor, Thai estimated GFR (eGFR) as well as Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations among obese patients, defined as body mass index (BMI) ≥25 kg/m2 with the reference measured GFR (mGFR) determined by 99mTc-diethylene triamine penta-acetic acid (99mTc-DTPA) plasma clearance method. Serum creatinine levels were measured using standardized enzymatic method simultaneously with GFR measurement. The statistical methods in assessing agreement for continuous data including total deviation index (TDI), concordance correlation coefficient (CCC), and coverage probability (CP) for each estimating equation were compared with the reference mGFR. Accuracy within 10% representing the percentage of estimations falling within the range of ±10% of mGFR values for all equations were also tested. Results A total of 240 Thai obese patients were finally recruited with mean BMI of 31.5 ± 5.8 kg/m2. In the total population, all eGFR equations underestimated the reference mGFR. The average TDI values were 55% indicating that 90% of the estimates falling within the range of -55 to +55% of the reference mGFR. The CP values averaged 0.23 and CCC scores ranged from 0.75 to 0.81, reflecting the low to moderate levels of agreement between each eGFR equation and the reference mGFR. The proportions of patients achieving accuracy 10% ranged from 23% for the reexpressed MDRD equation to 33% for the Thai eGFR formula. Among participants with BMI more than 35 kg/m2 (n = 48), the mean error of all equations was extremely wide and significantly higher for all equations compared with the lower BMI category. Also, the strength of agreement evaluated by TDI, CCC, and CP were low in the subset of patients with BMI ≥35 kg/m2. Conclusion Estimating equations generally underestimated the reference mGFR in subjects with obesity. The overall performance of GFR estimating equations demonstrated poor concordance with the reference mGFR among individuals with high BMI levels. In certain clinical settings such as decision for dialysis initiation, the direct measurements of GFR are required to establish real renal function among obese population.

show abstract

The Error of Estimated GFR in Type 2 Diabetes Mellitus

Cited by 15 publications

References 27 publications

Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study

Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study

A novel nomogram to predict the reliability of estimated glomerular filtration rate formulae in oncology patients

The failure of glomerular filtration rate estimating equations among obese population

Contact Info

Product

Resources

About