Accuracy of the MDRD (Modification of Diet in Renal Disease) Study and CKD-EPI (CKD Epidemiology Collaboration) Equations for Estimation of GFR in the Elderly

Kilbride, Hannah; Stevens, Paul E.; Eaglestone, Gillian; Knight, Sarah; Carter, Joanne L.; Delaney, Michael P.; Farmer, Chris; Irving, Jean; O'Riordan, Shelagh E; Dalton, R. Neil; Lamb, Edmund J.

doi:10.1053/j.ajkd.2012.06.016

Cited by 206 publications

(161 citation statements)

References 37 publications

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“…Several reports have demonstrated that eGFR based on the combination of both standardized serum creatinine and cystatin C is more accurate than eGFR based on either marker alone, [6][7][8] but there are few studies using standardized serum creatinine and cystatin C to evaluate these equations in elderly individuals. [9][10][11][12][13] Current guidelines recommend using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations for GFR estimation in clinical practice or other equations using standardized creatinine and cystatin C if they are more accurate than the CKD-EPI equations. 14 Among other equations, only the Japanese equations, 15,16 the Berlin Initiative Study (BIS) equations, 17 and the Caucasian and Asian pediatric and adult subjects (CAPA) equation 18 are based on standardized creatinine and standardized cystatin C assays.…”

mentioning

confidence: 99%

Comparing GFR Estimating Equations Using Cystatin C and Creatinine in Elderly Individuals

Fan

Levey

Gudnason

et al. 2015

Journal of the American Society of Nephrology

136

116

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Current guidelines recommend reporting eGFR using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations unless other equations are more accurate, and recommend the combination of creatinine and cystatin C (eGFRcr-cys) as more accurate than either eGFRcr or eGFRcys alone. However, preferred equations and filtration markers in elderly individuals are debated. In 805 adults enrolled in the community-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we measured GFR (mGFR) using plasma clearance of iohexol, standardized creatinine and cystatin C, and eGFR using the CKD-EPI, Japanese, Berlin Initiative Study (BIS), and Caucasian and Asian pediatric and adult subjects (CAPA) equations. We evaluated equation performance using bias, precision, and two measures of accuracy. We first compared the Japanese, BIS, and CAPA equations with the CKD-EPI equations to determine the preferred equations, and then compared eGFRcr and eGFRcys with eGFRcr-cys using the preferred equations. Mean (SD) age was 80.3 (4.0) years. Median (25th, 75th) mGFR was 64 (52, 73) ml/min per 1.73 m 2 , and the prevalence of decreased GFR was 39% (95% confidence interval, 35.8 to 42.5). Among 24 comparisons with the other equations, CKD-EPI equations performed better in 9, similar in 13, and worse in 2. Using the CKD-EPI equations, eGFRcr-cys performed better than eGFRcr in four metrics, better than eGFRcys in two metrics, and similar to eGFRcys in two metrics. In conclusion, neither the Japanese, BIS, nor CAPA equations were superior to the CKD-EPI equations in this cohort of community-dwelling elderly individuals. Using the CKD-EPI equations, eGFRcr-cys performed better than eGFRcr or eGFRcys.

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mentioning

confidence: 99%

Comparing GFR Estimating Equations Using Cystatin C and Creatinine in Elderly Individuals

Fan

Levey

Gudnason

et al. 2015

Journal of the American Society of Nephrology

136

116

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“…Between-batch imprecision (n = 48) was 2.6% at 6.89 mmol/L and 3.3% at 17.4 mmol/L. Plasma creatinine was measured using a reference stable isotope dilution electrospray MSMS as previously described (18,19). Between-batch imprecision (n = 30) was 2.8% at 66.1 mmol/L and 2.5% at 333.3 mmol/L.…”

Section: Biochemistrymentioning

confidence: 99%

Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT): Urinary Screening and Baseline Biochemical and Cardiovascular Assessments

Marcovecchio¹,

Woodside

Jones

et al. 2014

Diabetes Care

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OBJECTIVEWe assessed the association between early increases in albumin excretion and cardiovascular (CV) and renal markers in a large cohort of young people with type 1 diabetes. RESEARCH DESIGN AND METHODSAs part of preliminary screening for a multicenter, randomized controlled trial of statins/ACE inhibitors, we measured albumin-creatinine ratio (ACR) in six early morning urine samples from 3,353 adolescents (10-16 years of age) and calculated tertiles based on an established algorithm. From those subjects deemed to be at higher risk (upper ACR tertile), we recruited 400 into the intervention study (trial cohort). From those subjects deemed to be at lower risk (middle-lower ACR tertiles), we recruited 329 to the observation cohort. At baseline, vascular measurements (carotid intima-media thickness, pulse wave velocity [PWV], flow-mediated dilatation, digital pulse amplitude tonometry), renal markers (symmetric dimethylarginine, cystatin C, creatinine), and CV disease markers (lipids and apolipoproteins [Apo] A-1 and B, C-reactive protein, asymmetric dimethylarginine) were assessed. RESULTSAge-and sex-adjusted PWV was higher in the trial than in the observational cohort (5.00 6 0.84 vs. 4.86 6 0.70 m/s; P = 0.021). Similarly, non-HDL cholesterol (2.95 6 0.83 vs. 2.81 6 0.78 mmol/L; P = 0.02) and ApoB-ApoA-1 ratio (0.50 6 0.14 vs. 0.47 6 0.11; P = 0.04) were higher in the trial cohort. Cystatin C and creatinine were decreased (0.88 6 0.13 vs. 0.90 6 0.13 mg/L, P = 0.04; 51.81 6 10.45 vs. 55.35 6 11.05 mmol/L, P < 0.001; respectively) and estimated glomerular filtration rate (137.05 6 23.89 vs. 129.31 6 22.41 mL/min/1.73 m 2 ; P < 0.001) increased in the trial compared with the observational cohort. CONCLUSIONSOur data demonstrate that in adolescents with type 1 diabetes, the group with the highest tertile of albumin excretion showed more evidence of early renal and CV disease than those in the lower tertiles.

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“…En effet, l'application de ces é quations chez le sujet âgé peut se ré vé ler problé matique, car la masse musculaire diminue physiologiquement avec l'âge, ce qui modifie thé oriquement la relation entre DFG et cré atinine. La formule de Cockcroft n'est clairement pas un bon indicateur du DFG dans cette population [97][98][99][100]. Certes, à l'é chelle populationnelle, le biais moyen (c'est-à -dire l'erreur systé matique par rapport au DFG mesuré ) de la formule de Cockcroft, par rapport aux formules MDRD et CKD-EPI, est relativement bon [97,98].…”

Section: La Problé Matique Du Sujet âGéunclassified

“…Qui plus est, la pré cision de la formule est trè s insuffisante, ce qui en fait un estimateur discutable au niveau individuel [97,98]. La performance des formules MDRD et CKD-EPI a é té é tudié e en population âgé e [97][98][99][100][101]. En situation de population gé né rale (c'est moins le cas en population avec MRC), ces deux formules ont tendance à surestimer le DFG vrai, alors que leur pré cision reste meilleure, bien que sub-optimale, par rapport à la formule de Cockcroft.…”

Section: La Problé Matique Du Sujet âGéunclassified

Adaptation posologique des médicaments et fonction rénale : quel(s) estimateur(s) faut-il choisir ?

Delanaye

Flamant

Guerber³

et al. 2016

Néphrologie & Thérapeutique

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Le choix de la formule d'estimation du dé bit de filtration glomé rulaire (DFG) à utiliser pour l'adaptation posologique fait encore dé bat, principalement entre la formule de Cockcroft et les é quations plus ré centes, MDRD (pour Modified Diet in Renal Disease) et CKD-EPI (pour Chronic Kidney Disease Epidemiology). Les arguments mis en avant en faveur de l'utilisation de la formule de Cockcroft sont : qu'elle a é té pré fé rentiellement utilisé e pour dé cider des adaptations posologiques avant la mise sur le marché des mé dicaments, qu'elle permettrait une meilleure pré diction du risque de survenue des effets indé sirables à l'accumulation des mé dicaments, qu'elle permettrait de limiter le surdosage mé dicamenteux chez la personne âgé e. Dans cet article d'opinion, nous discutons les faiblesses de l'argumentaire des partisans du maintien de l'utilisation de la formule de Cockcroft dans le contexte de l'adaptation posologique, ainsi que les limites et le manque de fiabilité de cette formule. Nous soutenons la recommandation de la Haute Autorité de santé (HAS) sur l'utilisation systé matique, en 2015, de l'é quation CKD-EPI pour l'estimation du DFG. Lorsque le DFG est é valué dans le but d'adapter la posologie d'un mé dicament, la dé sindexation de la surface corporelle est pré fé rable. Compte tenu des difficulté s d'estimation du DFG chez la personne âgé e et chez les individus à gabarit hors norme, nous recommandons d'utiliser en priorité dans ces populations, des mé dicaments pour lesquels un suivi pharmacologique est disponible, ou d'avoir recours à une mé thode de ré fé rence de mesure du DFG.ß 2015 Association Socié té de né phrologie. Publié par Elsevier Masson SAS. Tous droits ré servé s.

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Accuracy of the MDRD (Modification of Diet in Renal Disease) Study and CKD-EPI (CKD Epidemiology Collaboration) Equations for Estimation of GFR in the Elderly

Cited by 206 publications

References 37 publications

Comparing GFR Estimating Equations Using Cystatin C and Creatinine in Elderly Individuals

Comparing GFR Estimating Equations Using Cystatin C and Creatinine in Elderly Individuals

Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT): Urinary Screening and Baseline Biochemical and Cardiovascular Assessments

Adaptation posologique des médicaments et fonction rénale : quel(s) estimateur(s) faut-il choisir ?

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