A New Modified CKD-EPI Equation for Chinese Patients with Type 2 Diabetes

Abstract

ObjectiveTo improve the performance of glomerular filtration rate (GFR) estimating equation in Chinese type 2 diabetic patients by modification of the CKD-EPI equation.Design and patientsA total of 1196 subjects were enrolled. Measured GFR was calibrated to the dual plasma sample 99mTc-DTPA-GFR. GFRs estimated by the re-expressed 4-variable MDRD equation, the CKD-EPI equation and the Asian modified CKD-EPI equation were compared in 351 diabetic/non-diabetic pairs. And a new modified CKD-EPI equation was reconstructed in a total of 589 type 2 diabetic patients.ResultsIn terms of both precision and accuracy, GFR estimating equations all achieved better results in the non-diabetic cohort comparing with those in the type 2 diabetic cohort (30% accuracy, P≤0.01 for all comparisons). In the validation data set, the new modified equation showed less bias (median difference, 2.3 ml/min/1.73 m2 for the new modified equation vs. ranged from −3.8 to −7.9 ml/min/1.73 m2 for the other 3 equations [P<0.001 for all comparisons]), as was precision (IQR of the difference, 24.5 ml/min/1.73 m2 vs. ranged from 27.3 to 30.7 ml/min/1.73 m2), leading to a greater accuracy (30% accuracy, 71.4% vs. 55.2% for the re-expressed 4 variable MDRD equation and 61.0% for the Asian modified CKD-EPI equation [P = 0.001 and P = 0.02]).ConclusionA new modified CKD-EPI equation for type 2 diabetic patients was developed and validated. The new modified equation improves the performance of GFR estimation.

Association Between Neutrophils and Renal Impairment of Rheumatoid Arthritis: A Retrospective Cross-sectional Study

“…Moreover, the SCr component of the CKD-EPI equation was linked to total muscle mass, and some RA patients also present with sarcopenia. Consequently, CKD-EPI SCr/CysC equations that depend on SCr to assess eGFR may overestimate kidney function in RA patients [44]. Information on the disease progression of RA and the composition of speci c medications (such as DMARDs) prescribed to each patient would have improved the estimation of renal function in the cohort of this study, however, missing data disquali ed any analysis regarding these two factors in this cohort.…”

Applying Random Forest Model Algorithm to GFR estimation

“…The measurement of standard GFR (sGFR) or measured GFR (mGFR) was radionuclide renal dynamic imaging or 99mTc-DTPA, which was described in detail before (13)(14)(15)22). Serum creatinine (SC) measurement was on Hitachi 7180 auto-analyzer (Hitachi, Tokyo, Japan) using reagents from Roche Diagnostics (Mannheim, Germany).…”

Clinical Significance of Cystatin C-Based Estimates of Renal Function in Type 2 Diabetic Patients: Review

“…It was also reported to achieve better results in the non-diabetic cohort comparing with those in the type 2 diabetic cohort [61]. Singla et al evaluated the role of cystatin C as an early biomarker of renal impairment in type 2 DM before the onset of microalbuminuria.…”