Reliability of CKD-EPI predictive equation in estimating chronic kidney disease prevalence in the Croatian endemic nephropathy area

Fuček, Mirjana; Dika, Živka; Karanović, Sandra; Brinar, Ivana Vuković; Premužić, Vedran; Kos, Jelena; Cvitković, Ante; Mišić, Maja; Samardžić, Josip; Rogić, Dunja; Jelaković, Bojan

doi:10.11613/bm.2018.010701

Cited by 3 publications

(4 citation statements)

References 18 publications

(15 reference statements)

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“…Forty two laboratories in our study still used the MDRD equation. Fuček et al showed that eGFR based on CKD-EPI equations correlated significantly with endemic nephropathy ( 16 ). Another new option for eGFRcrea is the Lund-Malmö equation ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Assessment of the degree of adherence of medical laboratories to KDIGO 2012 guideline for evaluation and management of CKD in Czechia and Slovakia

Skalický

Friedecký²,

Kratochvíla³

et al. 2019

Biochem. med. (Online)

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Introduction: The aim of the study is to assess the degree of adherence of medical laboratories to Kidney Disease Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (CKD) in laboratory practice in Czechia and Slovakia. Materials and methods: An electronic questionnaire on adherence to KDIGO 2012 guideline was designed by an external quality assessment (EQA) provider SEKK spol. s.r.o. The questionnaire was placed and distributed through website to all medical biochemistry laboratories in Czechia and Slovakia (N = 396). Results: A total of 212 out of 396 laboratories responded to the questions, though some laboratories only answered some questions, those applicable to their practice. A total of 48 out of 212 laboratories adopted the KDIGO 2012 guideline in full extent. The metrological traceability of creatinine measurement to standard reference material of SRM 967 was declared by 180 out of 210 laboratories (two of the responding laboratories did not measure creatinine). Thirty laboratories are not well educated on traceability of creatinine measurement and seven laboratories do not calculate estimated glomerular filtration rate (eGFR). Both urinary albumin concentration and albumin to creatinine ratio are reported by 144 out of 175 laboratories (37 of the responding laboratories did not measure urinary albumin). Conclusion: Majority of laboratories in Czechia and Slovakia adopted some parts of the KDIGO 2012 guideline in their practice, but only 23% of the laboratories apply them completely. Thus, further education and action should be conducted to improve its implementation.

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Section: Discussionmentioning

confidence: 99%

Assessment of the degree of adherence of medical laboratories to KDIGO 2012 guideline for evaluation and management of CKD in Czechia and Slovakia

Skalický

Friedecký²,

Kratochvíla³

et al. 2019

Biochem. med. (Online)

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“…This data was then processed to generate new candidate predictors based on data collected in the first 6 or 12 months post-transplantation, separately. Specifically, eGFR was calculated using the CKD-EPI equation, which is based on serum creatinine (Scr, μmol/L), gender, and age [ 34 ]. NLR, PLR, and MLR were generated via the divisions of neutrophil count, platelet count, and monocyte count by lymphocyte count, respectively.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of routine clinical laboratory data derived marker-based nomograms for the prediction of 5-year graft survival in kidney transplant recipients

Lin

et al. 2021

Aging

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Background: To develop and validate predictive nomograms for 5-year graft survival in kidney transplant recipients (KTRs) with easily-available laboratory data derived markers and clinical variables within the first year post-transplant. Methods: The clinical and routine laboratory data from within the first year post-transplant of 1289 KTRs was collected to generate candidate predictors. Univariate and multivariate Cox analyses and LASSO were conducted to select final predictors. X-tile analysis was applied to identify optimal cutoff values to transform potential continuous factors into category variables and stratify patients. C-index, calibration curve, dynamic time-dependent AUC, decision curve analysis, and Kaplan-Meier curves were used to evaluate models’ predictive accuracy and clinical utility. Results: Two predictive nomograms were constructed by using 0–6- and 0–12- month laboratory data, and showed good predictive performance with C-indexes of 0.78 and 0.85, respectively, in the training cohort. Calibration curves showed that the prediction probabilities of 5-year graft survival were in concordance with actual observations. Additionally, KTRs could be successfully stratified into three risk groups by nomograms. Conclusions: These predictive nomograms combining demographic and 0–6- or 0–12- month markers derived from post-transplant laboratory data could serve as useful tools for early identification of 5-year graft survival probability in individual KTRs.

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“…The reduction of metformin dose is recommended when eGFR is 30‐44 mL/min/1.73 m 2 (stage 3b) and discontinuation when eGFR is <30 mL/min/1.73 m 2 (stages 4 and 5). eGFR can be calculated from serum creatinine and/or cystatin C. eGFRcrea is the most common test for estimation of GFR in clinical practice . KDIGO guidelines recommend confirming eGFRcrea decline below 45 mL/min/1.73 m 2 by determination of eGFRcys or direct GFR measurement for metformin dosing .…”

Section: Introductionmentioning

confidence: 99%

“…eGFR can be calculated from serum creatinine and/or cystatin C. eGFRcrea is the most common test for estimation of GFR in clinical practice. 2 KDIGO guidelines recommend confirming eGFRcrea decline below 45 mL/min/1.73 m 2 by determination of eGFRcys or direct GFR measurement for metformin dosing. 3 Real-world practice of monitoring diabetic patients does not include the gold standard of GFR measurement.…”

Section: Introductionmentioning

confidence: 99%

Cystatin C measurement leads to lower metformin dosage in elderly type 2 diabetic patients

Skalický

Adamíková

2018

Basic Clin Pharma Tox

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The aim of this study was to provide evidence for the hypothesis that estimated glomerular filtration rate from serum Cystatin C (eGFRcys) is better to be determined for all elderly type 2 diabetes mellitus (T2DM) patients based on eGFRcys upward and downward reclassification rate for hypothetical metformin dose reduction by eGFRcys at the GFR decision point of 45 mL/min/1.73 m . A total of 265 consecutive T2DM elderly patients (age range 65-91 years) from outpatient diabetic clinic were included in the study. The Kidney Disease Improving Global Outcomes (KDIGO) guidelines for metformin dosing were strictly followed. Estimated glomerular filtration rate from serum creatinine (eGFRcrea) led to results of metformin eligibility. Each of the results of eGFRcrea-based eligibility was further compared to eGFRcys-based eligibility. Creatinine was measured by enzymatic method standardized against international reference material SRM 967. Cystatin C was determined by method traceable to DA ERM 471 international standard. eGFRcrea and eGFRcys were calculated according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. A downward reclassification rate was higher than upward reclassification rate (31 vs 3, respectively; P < 0.0001). The median (IQR) eGFRcrea was higher than eGFRcys (73 (58-85) vs 63 (50-75) mL/min/1.73 m , respectively; P < 0.0001). eGFRcys reclassified significant proportion of patients with T2DM from metformin eligible CKD stages to less or non-eligible stages. The downward reclassification was more frequent in patients older than 80 years (P < 0.01). Cystatin C-based eGFR selects more complicated patients, where lower doses of metformin are possibly advisable. We recommend calculating both eGFRcrea and eGFRcys for metformin dosing in elderly patients with T2DM.

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Reliability of CKD-EPI predictive equation in estimating chronic kidney disease prevalence in the Croatian endemic nephropathy area

Cited by 3 publications

References 18 publications

Assessment of the degree of adherence of medical laboratories to KDIGO 2012 guideline for evaluation and management of CKD in Czechia and Slovakia

Assessment of the degree of adherence of medical laboratories to KDIGO 2012 guideline for evaluation and management of CKD in Czechia and Slovakia

Development and validation of routine clinical laboratory data derived marker-based nomograms for the prediction of 5-year graft survival in kidney transplant recipients

Cystatin C measurement leads to lower metformin dosage in elderly type 2 diabetic patients

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