A new tool for predicting the probability of chronic kidney disease from a specific value of estimated GFR.
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Abstract
Abstract Objective. To demonstrate how patients' probability of having chronic kidney disease (CKD) stage 35 (measured GFR <60 mL/min/1.73 m(2)) can be predicted from a specific value of estimated glomerular filtration rate (eGFR). Material and methods. The probability of CKD stage 35 was predicted from a logistic regression model (n = 850) using three different eGFR prediction equations: LundMalmö, MDRD and CKDEPI. Population weighting was used to illustrate how this probability varies in three different populations: original sample (55% true prevalence of CKD stage 35), a screening (6.7% prevalence) and a CKD population (84% prevalence). Results. All three eGFRequations had high classification ability (area under the receiveroperatingcharacteristic curve = 97%). The probability of CKD stage 35 increased with decreasing eGFR, varied substantially among the populations studied and to some extent between the eGFRequations. Using the LundMalmö equation as illustration, the probability of CKD stage 35 is > 90% only when eGFR is <38 mL/min/1.73 m(2) in a screening population, whereas it is > 90% already when eGFR is <51 mL/min/1.73 m(2) in a CKD population. Conversely, the probability of CKD stage 35 is <10% if eGFR > 59 mL/min/1.73 m(2) in a screening population, whereas it is <10% only when eGFR is > 88 mL/min/1.73 m(2) in a CKD population. Conclusion. Instead of reporting diagnostic accuracy as sensitivity, specificity, and predictive values, actual eGFR supplemented with the probability that it represents a true GFR <60 mL/min/1.73 m(2) may be more valuable for physicians. Clinical (pretest) probability in the population must be considered when predicting this probability.
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Research areas and keywords  Subject classification (UKÄ) – MANDATORY

Original language  English 

Pages (fromto)  327333 
Journal  Scandinavian Journal of Clinical and Laboratory Investigation 
Volume  Jul 1 
Publication status  Published  2010 
Publication category  Research 
Peerreviewed  Yes 