Startseite 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
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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

  • Francisco Veríssimo Veronese EMAIL logo , Eduardo C. Gomes , Joana Chanan , Maicon A. Carraro , Eduardo G. Camargo , Ariana A. Soares , Fernando S. Thomé und Sandra P. Silveiro
Veröffentlicht/Copyright: 18. Juni 2014
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Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 52 Heft 12

Abstract

Background: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals.

Methods: This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by the 51Cr-EDTA single-injection method (51Cr-GFR). Accuracy (P30), bias, and Bland-Altman agreement plots were evaluated.

Results: In the group as a whole, 51Cr-GFR was 87±37 (6-187), CKD-EPI eGFR, 82±30 (6-152), and MDRD eGFR, 77±28 (6-156) mL/min/1.73 m2 (p<0.001 for all comparisons). Analyzing the subset of individuals with 51Cr-GFR <60 mL/min/1.73 m2, P30 values were, respectively, 76% and 84% for MDRD and for CKD-EPI (p<0.001) while for 51Cr-GFR ≥60 mL/min/1.73 m2, P30 values were 57.5% for both equations (p=1.000). For MDRD and CKD-EPI, mean bias were negative for GFRs <60 (–11 vs. –12, p=0.221) and positive for values >60 (16 vs. 9, p<0.001). In multivariate analysis, absolute bias was unfavorably influenced by measured GFR >60 (for MDRD) and being diabetic or younger (for CKD-EPI).

Conclusions: CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m2. CKD stages 1 and 2, diabetes and young age had a negative influence on the performance of the equations.

Keywords: chronic kidney disease; CKD-EPI; creatinine; 51chromium-EDTA; glomerular filtration rate; Modification of Diet in Renal Disease (MDRD)
Corresponding author: Francisco Veríssimo Veronese, MD, PhD, Nephrology Division, Room 2030, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos 2350, Porto Alegre, RS, 90035-003, Brazil, Fax: +55 51 3359-8121, E-mail:

Acknowledgments

The authors thank the Hospital de Clínicas de Porto Alegre Research Funding (FIPE) for supporting this research project, and to Osmar Magalhães de Oliveira and Viviane Grohmann of the Nuclear Medicine Unit of Hospital de Clínicas de Porto Alegre for their technical support. The authors also thank Vania Naomi Hirakata for statistical assistance.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article. Research support played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

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Received: 2014-1-15
Accepted: 2014-5-21
Published Online: 2014-6-18
Published in Print: 2014-12-1

©2014 by De Gruyter

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https://doi.org/10.1515/cclm-2014-0052
Schlagwörter für diesen Artikel
chronic kidney disease; CKD-EPI; creatinine; 51chromium-EDTA; glomerular filtration rate; Modification of Diet in Renal Disease (MDRD)

Artikel in diesem Heft

  1. Frontmatter
  2. Editorials
  3. CCLM Award for The Most Cited Paper Recently Published
  4. Laboratory preparedness to face infectious outbreaks. Ebola and beyond
  5. Reviews
  6. Determination of reference limits: statistical concepts and tools for sample size calculation
  7. Recent advances in physiological lipoprotein metabolism
  8. New laboratory markers for the management of rheumatoid arthritis patients
  9. General Clinical Chemistry and Laboratory Medicine
  10. The impact of repeat-testing of common chemistry analytes at critical concentrations
  11. 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
  12. The serum uromodulin level is associated with kidney function
  13. Efficient assessment of peripheral blood lymphocytosis in adults: developing new thresholds for blood smear review by pathologists
  14. Performance evaluation of Sysmex XN hematology analyzer in umbilical cord blood: a comparison study with Sysmex XE-2100
  15. UF-1000i: validation of the body fluid mode for counting cells in body fluids
  16. Newborn screening for haemoglobinopathies by high performance liquid chromatography (HPLC): diagnostic utility of different approaches in resource-poor settings
  17. Progressive chromogenic anti-factor Xa assay and its use in the classification of antithrombin deficiencies
  18. Reference Values and Biological Variations
  19. Thyroid-stimulating hormone reference range and factors affecting it in a nationwide random sample
  20. Reference ranges for serum β-trace protein in neonates and children younger than 1 year of age
  21. A multicenter nationwide reference intervals study for common biochemical analytes in Turkey using Abbott analyzers
  22. Serum reference intervals of homoarginine, ADMA, and SDMA in the Study of Health in Pomerania
  23. Cancer Diagnostics
  24. Low SOX17 expression: prognostic significance in de novo acute myeloid leukemia with normal cytogenetics
  25. Results of first proficiency test for KRAS testing with formalin-fixed, paraffin-embedded cell lines in China
  26. Aberrant hypermethylation of CTNNA1 gene is associated with higher IPSS risk in patients with myelodysplastic syndrome
  27. Cardiovascular Diseases
  28. Association between SNP rs13376333 and rs1131820 in the KCNN3 gene and atrial fibrillation in the Chinese Han population
  29. Acknowledgment
  30. Acknowledgment
  31. Letters to the Editor
  32. Interference in thyroid hormones with Roche immunoassays: an unfinished story
  33. Discrepant results in plasma, but not serum in the Beckman Coulter DxI Access HYPERsensitive hTSH 3rd generation assay affect the management of differentiated thyroid cancer and hyperthyroid patients
  34. Improper serum separation on gel tubes: a trivial laboratory problem or an indicator of monoclonal gammopathy?
  35. Analytical comparison of the new point-of-care troponin T immunoassay on AQT90Flex® analyzer (Radiometer) and the high-sensitivity troponin T immunoassay on ModularE170® (Roche Diagnostics)
  36. Performance characteristics of the enzymatic Abbott Architect HbA1c whole blood assay
  37. Multi-center proficiency tests for Lab-MELD score diagnostics to improve the quality and safety for patients awaiting liver transplantation
  38. The apolipoprotein B/apolipoprotein A-I ratio in healthy men with normolipidemia: limits of variation and relationship with other lipid parameters
  39. Validity and reliability of the 13C-methionine breath test for the detection of moderate hyperhomocysteinemia in Mexican adults; statistical issues in validity and reliability analysis
  40. Enzymatic and endpoint methods yield comparable adenosine deaminase activity in pleural fluid samples
  41. Congress Abstract
  42. 5th Italian GREAT Network Congress
  43. Congress of Laboratory Medicine and Clinical Chemistry
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