The CKD-EPI and MDRD equations to estimate GFR. Validation in the Swedish Lund-Malmo Study cohort

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T1 - The CKD-EPI and MDRD equations to estimate GFR. Validation in the Swedish Lund-Malmo Study cohort

AU - Nyman, Ulf

AU - Grubb, Anders

AU - Sterner, Gunnar

AU - Björk, Jonas

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Occupational and Environmental Medicine (013078001), Emergency medicine/Medicine/Surgery (013240200), Division of Clinical Chemistry and Pharmacology (013250300)

PY - 2011

Y1 - 2011

N2 - Objective. To compare the recently developed CKD-EPI equation to estimate GFR in adult Swedish-Caucasians with the MDRD equation. Material and methods. Swedish-Caucasians (N = 850, 376 females; median age 60, range 5-95 years) referred for plasma iohexol-clearance (median 55, range 5-223 mL/min/1.73 m(2)) constituted the Lund-Malmo Study cohort. Bias, precision (interquartile range, IQR, of the differences between estimated and measured GFR), accuracy expressed as percentage of estimates +/- 10% (P-10) and +/- 30% (P-30) of measured GFR, and classification ability for five GFR stages < 15, 15-29, 30-59, 60-89 and >= 90 mL/min/1.73 m(2) were compared. Results. Overall there were no important differences between the equations; CKD-EPI/MDRD median values of bias +5.4%/+3.4%, IQR both 14 mL/min/1.73 m(2), P-10 36%/34%, P-30 both 80%, and correctly classified GFR stages 68%/67%. P-30 for the CKD-EPI equation was substantially higher than for MDRD at GFR >= 90 mL/min/1.73 m(2) (93% versus 79%). The MDRD equation performed better in the GFR interval 30-89 mL/min/1.73 m(2), while accuracy was limited for both equations at GFR < 30 mL/min/1.73 m(2) (P-30 < 75% in both females and males). The CKD-EPI/MDRD equations caused a +22%/ +14% bias in the 18-39 year interval and the MDRD equation a + 18% bias >= 80 years. Both equations performed poorly in males with BMI < 20 kg/m(2) (CKD-EPI/MDRD median bias +36%/46%). Conclusion. Overall the recently developed CKD-EPI equation performed well but was not superior to the MDRD equation. The CKD-EPI equation may be preferred in screenings of general populations and in the elderly. None of the equations appeared reliable among patients with markedly decreased GFR, young adults and underweight males.

AB - Objective. To compare the recently developed CKD-EPI equation to estimate GFR in adult Swedish-Caucasians with the MDRD equation. Material and methods. Swedish-Caucasians (N = 850, 376 females; median age 60, range 5-95 years) referred for plasma iohexol-clearance (median 55, range 5-223 mL/min/1.73 m(2)) constituted the Lund-Malmo Study cohort. Bias, precision (interquartile range, IQR, of the differences between estimated and measured GFR), accuracy expressed as percentage of estimates +/- 10% (P-10) and +/- 30% (P-30) of measured GFR, and classification ability for five GFR stages < 15, 15-29, 30-59, 60-89 and >= 90 mL/min/1.73 m(2) were compared. Results. Overall there were no important differences between the equations; CKD-EPI/MDRD median values of bias +5.4%/+3.4%, IQR both 14 mL/min/1.73 m(2), P-10 36%/34%, P-30 both 80%, and correctly classified GFR stages 68%/67%. P-30 for the CKD-EPI equation was substantially higher than for MDRD at GFR >= 90 mL/min/1.73 m(2) (93% versus 79%). The MDRD equation performed better in the GFR interval 30-89 mL/min/1.73 m(2), while accuracy was limited for both equations at GFR < 30 mL/min/1.73 m(2) (P-30 < 75% in both females and males). The CKD-EPI/MDRD equations caused a +22%/ +14% bias in the 18-39 year interval and the MDRD equation a + 18% bias >= 80 years. Both equations performed poorly in males with BMI < 20 kg/m(2) (CKD-EPI/MDRD median bias +36%/46%). Conclusion. Overall the recently developed CKD-EPI equation performed well but was not superior to the MDRD equation. The CKD-EPI equation may be preferred in screenings of general populations and in the elderly. None of the equations appeared reliable among patients with markedly decreased GFR, young adults and underweight males.

KW - Kidney disease

KW - kidney function tests

KW - glomerular filtration rate

KW - renal insufficiency

U2 - 10.3109/00365513.2010.543143

DO - 10.3109/00365513.2010.543143

M3 - Article

VL - 71

SP - 129

EP - 138

JO - Scandinavian Journal of Clinical & Laboratory Investigation

T2 - Scandinavian Journal of Clinical & Laboratory Investigation

JF - Scandinavian Journal of Clinical & Laboratory Investigation

SN - 1502-7686

IS - 2

ER -