Comparative Performance of the CKD Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) Study Equations for Estimating GFR Levels Above 60 mL/min/1.73 m2

Abstract

Background The MDRD Study equation underestimates measured GFR at levels greater than 60 ml/min per 1.73 m2, with variable accuracy among subgroups; consequently estimated GFR (eGFR) ≥ 60 ml/min/1.73 m2 is not reported by clinical laboratories. Here, the performance of a more accurate GFR estimating equation, the CKD-EPI equation, is reported by level of GFR and clinical characteristics. Study Design Test of diagnostic accuracy Setting and Participants Pooled dataset of 3896 people from 16 studies with measured GFR (not used for development of either equation). Subgroups were defined by eGFR, age, sex, race, diabetes, prior solid organ transplant, and body mass index. Index Tests eGFR from the CKD-EPI and MDRD Study equations and standardized serum creatinine Reference Test Measured GFR using urinary or plasma clearance of exogenous filtration markers Results Mean (SD) measured GFR was 68 (36) ml/min/1.73 m2. For eGFR less than 30 ml/min/1.73 m2, both equations have similar bias (median difference compared to measured GFR). For eGFR between 30-59 ml/min/1.73 m2, bias was reduced from 4.9 to 2.1 ml/min/1.73 m2 (57% improvement). For eGFR between 60-89 ml/min/1.73 m2, bias was reduced from 11.9 to 4.2 ml/min/1.73 m2 (61 % improvement). For eGFR between 90-119 ml/min/1.73 m2, bias was reduced from 10.0 to 1.9 ml/min/1.73 m2 (75% improvement). Similar or improved performance was noted for most subgroups with eGFR < 90 ml/min/1.73 m2, other than BMI less than 20 kg/m2, with greater variation noted for some subgroups with eGFR ≥ 90 ml/min/1.73 m2. Limitations Limited number of elderly people and racial and ethnic minorities with measured GFR. Conclusions The CKD-EPI equation is more accurate than the MDRD Study equation overall and across most subgroups. In contrast to the MDRD Study equation, eGFR ≥ 60 ml/min/1.73 m2 can be reported using the CKD-EPI equation.

Perturbations of the anti-ageing hormone Klotho in patients with type 1 diabetes and microalbuminuria

“…HbA 1c was measured by boronate affinity HPLC (Primus CLC330, Kansas City, MO, USA). eGFR was determined using the Chronic Kidney Disease Epidemiology Collaboration Formula (CKD-EPI) [7].…”

Temporal Trajectory of B-Type Natriuretic Peptide in Patients with CKD Stages 3 and 4, Dialysis, and Kidney Transplant

“…We defined CKD 3-4 according to an eGFR,60 ml/min per 1.73 m 2 on two occasions using the Modification of Diet in Renal Disease (MDRD) equation 7 (9). Although the CKD-Epidemiology Collaboration equation has replaced the MDRD equation at our institution, the MDRD equation was used at the time patients were recruited to this study; the patients with CKD 3-4 had GFR in the lower range, where the MDRD equation performs best (10). Baseline data were recorded, and blood samples were collected at baseline and on one occasion a median of 161 (interquartile range [IQR], 139-189) days later.…”

Risk factors of long-term postoperative renal function after partial nephrectomy in a solitary kidney

“…php). In middle-aged and elderly population, the CKD-EPI equation is superior to the modification of diet in renal disease formula, especially when actual GFR is greater than 60 mL/min per 1.73 m 2 [8]. Measurement of the resected volume of normal kidney was used to indicate the residual kidney volume, as measurements of the preserved kidney volume were inaccurate.…”