Comparison of the MDRD and the CKD-EPI equations to estimate the glomerular filtration rate in the general population

López-Suárez, A.; Beltrán-Robles, Manuel; Elvira-González, Javier; Palacín, Fernando Fernández; Bascuñana-Quirell, Antonio; Benítez-Del-Castillo, Julio; Gómez-Fernández, Pablo

doi:10.1016/j.medcli.2009.07.055

Cited by 16 publications

(9 citation statements)

References 29 publications

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“…35 Finally, in the López-Suárez et al study, the CKD-EPI equation may have overestimated the degree of decrease in kidney function in normoalbuminuric women. 25 In sum, as we have previously alluded to, 3 this literature suggests that the additional contribution of albuminuria and/or eGFR measures may vary based on the population, its diabetes prevalence, and on the outcomes of interest.…”

Section: Discussionmentioning

confidence: 82%

“…22,23, 24 In a Spanish study, the prevalence of decreased kidney function was observed to be substantially reduced in participants with diabetes, hypertension, and CVD. 25 Recent studies have shown that the CKD-EPI equation correctly reclassifies people at lower risk of CKD and death into higher eGFR categories. 26,27 Compared with the MDRD Study equation, the CKD-EPI equation suggested lower prevalence of CKD in the KEEP (Kidney Early Evaluation Program) study, a predominantly white population with relatively low prevalence of obesity or diabetes, but similar diabetes prevalence rates associated with CKD across all stages.…”

Section: Discussionmentioning

confidence: 99%

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Estimated GFR and Incident Cardiovascular Disease Events in American Indians: The Strong Heart Study

Shara

Wang

Méte

et al. 2012

American Journal of Kidney Diseases

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Estimated GFR and Incident Cardiovascular Disease Events in American Indians: The Strong Heart Study

Shara

Wang

Méte

et al. 2012

American Journal of Kidney Diseases

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“…In a study of adults without renal disease, the MDRD equation was more precise and accurate for predicting GFR compared with Cockcroft‐Gault equation, whereas in a study performed in the general population, the CKD‐EPI equation estimated a lower prevalence of renal impairment compared with the MDRD equation . This last result was confirmed in a meta‐analysis comparing CKD‐EPI with MDRD, in which the CKD‐EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and end‐stage renal disease .…”

Section: Discussionmentioning

confidence: 90%

“…Comparisons of receiver operating characteristic curves were performed by the method of DeLong et al 8 Discrimination and reclassification performance of the 3 equations was evaluated by calculating the integrated discrimination improvement and the net reclassification improvement, as described by Pencina et al 9 We also estimated the clinical usefulness and the net benefit of the 3 equations using the decision curve analysis, according to the methods proposed by Vickers et al 10,11 P<0.05 was accepted as statistically significant. Statistical analyses were performed using SPSS, version 22.0 (SPSS, Inc, Chicago, IL), MedCalc, version 16…”

Section: Discussionmentioning

confidence: 99%

Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome

Rivera‐Caravaca

Ruiz-Nodar

Tello‐Montoliu

et al. 2018

JAHA

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BackgroundA simple method to assess renal function is the estimated glomerular filtration rate, and it shows prognostic implications. However, it remains unknown which equation should be used in patients with acute coronary syndrome. We compared the ability and correlation of the Cockcroft‐Gault, Modification of Diet in Renal Disease‐4 (MDRD‐4), and Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equations and their predictive performance for major adverse cardiovascular events, all‐cause mortality, and major bleeding in a cohort of patients with acute coronary syndrome.Methods and ResultsMulticenter prospective registry involving 1699 consecutive patients with acute coronary syndrome from 3 tertiary institutions. At entry, renal function was assessed using the Cockcroft‐Gault, MDRD‐4, and CKD‐EPI‐creatinine equations. During 12 months of follow‐up, we recorded all major adverse cardiovascular events (composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal ischemic stroke), bleeding events (Bleeding Academic Research Consortium classification), and all‐cause mortality. Receiver operating characteristic curve comparisons demonstrated that Cockcroft‐Gault equation had higher predictive ability compared with MDRD‐4 equation for major adverse cardiovascular events (0.651 versus 0.616; P=0.023), major bleeding (0.600 versus 0.551; P=0.005), and all‐cause mortality (0.754 versus 0.717; P=0.033), as well as higher predictive ability compared with CKD‐EPI equation for major bleeding (0.600 versus 0.564; P=0.018). Integrated discrimination improvement and net reclassification improvement analyses showed superior discrimination and reclassification of Cockcroft‐Gault equation. Decision curve analyses graphically demonstrated higher net benefit and clinical usefulness of the Cockcroft‐Gault equation in comparison with MDRD‐4 and CKD‐EPI equations.ConclusionsIn patients with acute coronary syndrome, the Cockcroft‐Gault equation presented superior predictive ability for major adverse cardiovascular events, major bleeding, and all‐cause mortality compared with MDRD‐4 equation, and superior predictive ability for major bleeding compared with CKD‐EPI equation. The Cockcroft‐Gault equation also showed higher net benefit and clinical usefulness.

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“…It has been shown to be valid in similar populations but may underestimate measured GFR at the higher range leading to misclassification to a lower category and thus over diagnosis of CKD. Thereby, in 2009 a recent adaption for estimating GFR, the CKD-EPI equation, may overcome the limitations of MDRD in earlier stages for screening, detection, and classification of CKD (table 1) [26,27,28,29]. The CKD-EPI equation was developed using data from 8,254 people and validated in a separate data set of 3,896.…”

Section: Detection Of Ckd In Early Stagesmentioning

confidence: 99%

A Case for Early Screening for Diabetic Kidney Disease

Whaley‐Connell

Chaudhary²,

Misra³

et al. 2011

Cardiorenal Med

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Chronic kidney disease (CKD) is a public health dilemma contributing to increasing global morbidity and mortality. There is increasing recognition that early detection and management of CKD is critical in delaying disease progression as well as improving mortality rates. However, kidney disease is a silent process and usually goes undetected until more advanced stages, wherein the opportunity to intervene and improve kidney-related outcome is diminished, since awareness of CKD is low in earlier stages. Herein, we will review the screening and detection strategies for CKD as well as the importance of intervention in early stages to reduce progression and also the burden of CKD.

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Comparison of the MDRD and the CKD-EPI equations to estimate the glomerular filtration rate in the general population

Cited by 16 publications

References 29 publications

Estimated GFR and Incident Cardiovascular Disease Events in American Indians: The Strong Heart Study

Estimated GFR and Incident Cardiovascular Disease Events in American Indians: The Strong Heart Study

Disparities in the Estimation of Glomerular Filtration Rate According to Cockcroft‐Gault, Modification of Diet in Renal Disease‐4, and Chronic Kidney Disease Epidemiology Collaboration Equations and Relation With Outcomes in Patients With Acute Coronary Syndrome

A Case for Early Screening for Diabetic Kidney Disease

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