Comparison of prediction equations to estimate glomerular filtration rate in Chinese patients with chronic kidney disease

Liu, X.; Lv, Linsheng; Wang, C.; Chen, Shi; Cheng, Cailian; Tang, Hua; Chen, Z.; Ye, Z.; Lou, Tanqi

doi:10.1111/j.1445-5994.2010.02398.x

Cited by 15 publications

(15 citation statements)

References 24 publications

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“…In addition, the choice of Cr determination may also affect the applicability of eGFR1 and eGFR2. It was reported that eGFR1 was better than eGFR2 when the enzyme-based measurement was selected [41]. A similar conclusion was reached in this study.…”

Section: Discussionsupporting

confidence: 91%

Multicenter Study of Creatinine- and/or Cystatin C-Based Equations for Estimation of Glomerular Filtration Rates in Chinese Patients with Chronic Kidney Disease

et al. 2013

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Objective To establish equations for the estimation of glomerular filtration rates (eGFRs) based on serum creatinine (SCr) and/or serum cystatin C (SCysC) in Chinese patients with chronic kidney disease (CKD), and to compare the new equations with both the reference GFR (rGFR) and the literature equations to evaluate their applicability.Methods The 788 Chinese CKD patients were randomly divided into two groups, the training group and the testing group, to establish new eGFR-formulas based on serum CysC and to validate the established formulas, respectively. 99mTc-DTPA clearance (as the rGFR), serum Cr, and serum CysC were determined for all patients, and GFR was calculated using the Cockcroft-Gault equation (eGFR1), the MDRD formula (eGFR2), the CKD-EPI formulas (eGFR3, eGFR4), and the Chinese eGFR Investigation Collaboration formulas (eGFR5, eGFR6). The accuracy of each eGFR was compared with the rGFR.Results The training and testing groups' mean GFRs were 50.84±31.36 mL/min/1.73 m2 and 54.16±29.45 mL/min/1.73 m2, respectively. The two newly developed eGFR formulas were fitted using iterative computation: and . Significant correlation was observed between each eGFR and the rGFR. However, proportional errors and constant errors were observed between rGFR and eGFR1, eGFR2, eGFR4, eGFR5 or eGFR6, and constant errors were observed between eGFR3 and rGFR, as revealed by the Passing & Bablok plot analysis. The Bland-Altman analysis illustrated that the 95% limits of agreement of all equations exceeded the previously accepted limits of <60 mL/min •1.73 m2, except the equations of eGFR7 and eGFR8.Conclusion The newly developed formulas, eGFR7 and eGFR8, provide precise and accurate GFR estimation using serum CysC detection alone or in combination with serum Cr detection. Differences in detection methods should be carefully considered when choosing literature eGFR equations to avoid misdiagnosis and mistreatment.

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Section: Discussionsupporting

confidence: 91%

Multicenter Study of Creatinine- and/or Cystatin C-Based Equations for Estimation of Glomerular Filtration Rates in Chinese Patients with Chronic Kidney Disease

et al. 2013

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“…[13] The long-term effect of metformin treatment on the risk of cardiovascular disease remains largely unclear. [20] In addition, a previous study showed that, although treatment with valsartan for 24 months did not influence CCA-IMT, it did improve vascular wall function in patients with essential hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…The insulin resistance index was evaluated based on the homeostasis model assessment of insulin resistance (HOMA-IR), as described previously, [12] according to the following equation: (FPG [mmol/L]) × (FINS [μU/mL])/22.5. Glomerular filtration rate (GFR) was measured with 99m Tc-DTPA renal dynamic imaging using a Millennium TMMPR SPECT (GE Healthcare Life Sciences, Pittsburgh, PA), as described previously, [13] and the GFR was calculated based on the traditional MDRD equation. [14] The IMT of the common carotid artery (CCA), femoral artery (FA), and common iliac artery (CIA) were evaluated as described previously.…”

Section: Participants and Methodsmentioning

confidence: 99%

Long-term effects intensive medical therapy on the development and progression of subclinical atherosclerosis and the metabolic syndrome in Chinese patients with type 2 diabetes mellitus

et al. 2016

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Background:Few studies have investigated the progression of subclinical atherosclerosis and metabolic syndrome (MetS) in Chinese patients with type 2 diabetes mellitus (T2DM). This study was to compare the long-term effects of intensive medical therapy on the development and progression of subclinical atherosclerosis and MetS in Chinese T2DM patients with that of a conventional treatment regimen.Methods:A total of 316 T2DM patients were randomized to receive conventional pharmacological treatment or intensive medical therapy, consisting of diet and exercise counseling, from 2002 to 2014 at our hospital in Changsha, China. Clinical indicators of subclinical atherosclerosis and MetS were evaluated over the 12-year follow-up period. A χ2 analysis or t tests was used to compare the data between the 2 groups. Risk factors for subclinical atherosclerosis were identified using Cox proportional hazard models.Results:The incidence of subclinical atherosclerosis increased in both groups over time, and did not differ significantly between the 2 groups at the end of the study. However, after 6 years of treatment, the risk of subclinical atherosclerosis was significantly lower in the intensive medical therapy group, based on intima-media thickness (IMT) measurements, compared with that in the conventional treatment (44.2% vs. 69.7%; P < 0.01). Age, creatinine, and IMT of the common iliac artery were significantly associated with subclinical atherosclerosis. Although the indicators of MetS did not differ significantly at the end of study, the success rate for the management of MetS in the intensive medical therapy group was significantly higher than that in the conventional treatment group in 2006, 2008, 2010, and 2012.Conclusions:The incidence of atherosclerosis in the intensive medical therapy group was significantly lower than that in the conventional treatment group from 2006 to 2010 (P < 0.05), and the incidence of MetS in the intensive medical therapy group was significantly higher than that in the conventional treatment group from 2006 to 2012. Kaplan–Meier estimations showed that the risk of subclinical atherosclerosis in the intensive medical therapy group was significantly lower than that in the conventional treatment group (P < 0.001), whereas the risk of MetS was not significantly different between the treatment groups (P > 0.05).

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“…A Millennium TMMPR SPECT with a General Electric Medical System was used to measure 99 m Tc-DTPA renal dynamic imaging as previously described [26]. There was good agreement between 99 m Tc-DTPA renal imaging and plasma clearance of 51 chromium ethylenediamine tetraacetic acid [27].…”

Section: Methodsmentioning

confidence: 99%

Improved Glomerular Filtration Rate Estimation by an Artificial Neural Network

Liu

Pei

et al. 2013

PLoS ONE

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BackgroundAccurate evaluation of glomerular filtration rates (GFRs) is of critical importance in clinical practice. A previous study showed that models based on artificial neural networks (ANNs) could achieve a better performance than traditional equations. However, large-sample cross-sectional surveys have not resolved questions about ANN performance.MethodsA total of 1,180 patients that had chronic kidney disease (CKD) were enrolled in the development data set, the internal validation data set and the external validation data set. Additional 222 patients that were admitted to two independent institutions were externally validated. Several ANNs were constructed and finally a Back Propagation network optimized by a genetic algorithm (GABP network) was chosen as a superior model, which included six input variables; i.e., serum creatinine, serum urea nitrogen, age, height, weight and gender, and estimated GFR as the one output variable. Performance was then compared with the Cockcroft-Gault equation, the MDRD equations and the CKD-EPI equation.ResultsIn the external validation data set, Bland-Altman analysis demonstrated that the precision of the six-variable GABP network was the highest among all of the estimation models; i.e., 46.7 ml/min/1.73 m2 vs. a range from 71.3 to 101.7 ml/min/1.73 m2, allowing improvement in accuracy (15% accuracy, 49.0%; 30% accuracy, 75.1%; 50% accuracy, 90.5% [P<0.001 for all]) and CKD stage classification (misclassification rate of CKD stage, 32.4% vs. a range from 47.3% to 53.3% [P<0.001 for all]). Furthermore, in the additional external validation data set, precision and accuracy were improved by the six-variable GABP network.ConclusionsA new ANN model (the six-variable GABP network) for CKD patients was developed that could provide a simple, more accurate and reliable means for the estimation of GFR and stage of CKD than traditional equations. Further validations are needed to assess the ability of the ANN model in diverse populations.

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Comparison of prediction equations to estimate glomerular filtration rate in Chinese patients with chronic kidney disease

Abstract: When SC was measured by the enzymatic method, GFR estimation equations showed great bias in Chinese CKD patients. At present, the Jelliffe-1973 equation and Cockcroft-Gault equation may be more accurate in the Chinese ethnic group.

Cited by 15 publications

References 24 publications

Multicenter Study of Creatinine- and/or Cystatin C-Based Equations for Estimation of Glomerular Filtration Rates in Chinese Patients with Chronic Kidney Disease

Multicenter Study of Creatinine- and/or Cystatin C-Based Equations for Estimation of Glomerular Filtration Rates in Chinese Patients with Chronic Kidney Disease

Long-term effects intensive medical therapy on the development and progression of subclinical atherosclerosis and the metabolic syndrome in Chinese patients with type 2 diabetes mellitus

Improved Glomerular Filtration Rate Estimation by an Artificial Neural Network

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