Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function

Campbell, Duncan J.; Coller, J.; Gong, Fei; McGrady, Michele; Boffa, Umberto; Shiel, Louise; Liew, Danny; Stewart, Simon; Owen, Alice; Krum, Henry; Reid, Christopher M.; Prior, David

doi:10.1186/s12882-021-02324-y

Cited by 6 publications

(18 citation statements)

References 49 publications

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“…Logistic analysis was performed to analyze the risk factors for rapid eGFR decline. After adjusting for baseline gender, age, UACR, serum creatinine, homocysteine, urine NAG/Cr and HbA1c, which were reported as risk factors of eGFR decline in previous studies ( 17 – 20 ), our logistic regression analysis showed there was a significant correlation between anemia and rapid eGFR decline, which indicated that anemia was an independent risk factor of rapid eGFR decline. Anemia increased the risk of rapid eGFR decline by 66% ( Table 6 ).…”

Section: Resultsmentioning

confidence: 56%

Anemia is a risk factor for rapid eGFR decline in type 2 diabetes

Xie

Shao

et al. 2023

Front. Endocrinol.

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ObjectiveTo investigate the association between anemia and progression of diabetic kidney disease (DKD) in type 2 diabetes.MethodsThis was a retrospective study. A total of 2570 in-patients with type 2 diabetes hospitalized in Jinan branch of Huashan hospital from January 2013 to October 2017 were included, among whom 526 patients were hospitalized ≥ 2 times with a median follow-up period of 2.75 years. Annual rate of eGFR decline was calculated in patients with multiple admissions. A rate of eGFR decline exceeding -5 ml/min per 1.73 m2 per year was defined as rapid eGFR decline. The prevalence of DKD and clinical characteristics were compared between anemia and non-anemia patients. Correlation analysis was conducted between anemia and clinical parameters. Comparison of clinical features were carried out between rapid eGFR decline and slow eGFR decline groups. The risk factors for rapid DKD progression were analyzed using logistic regression analysis.ResultsThe prevalence of anemia was 28.2% among the 2570 diabetic patients, while in patients with DKD, the incidence of anemia was 37.8%. Patients with anemia had greater prevalence of DKD, higher levels of urinary albumin-to-creatinine ratio (UACR), serum creatinine, BUN, urine α1-MG, urine β2-MG, urine NAG/Cr, hsCRP, Cystatin C, homocysteine and lower eGFR, as compared to the patients without anemia. Anemia was correlated with age, UACR, eGFR, urinary NAG/Cr, hsCRP and diabetic retinopathy (DR). Logistic regression analysis of 526 patients with type 2 diabetes during the follow-up period showed that anemia was an independent risk factor for rapid eGFR decline.ConclusionAnemia is associated with worse renal function and is an independent risk factor for rapid eGFR decline in type 2 diabetes.

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Section: Resultsmentioning

confidence: 56%

Anemia is a risk factor for rapid eGFR decline in type 2 diabetes

Xie

Shao

et al. 2023

Front. Endocrinol.

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“…However, the KDIGO criteria that define CKD are a subject of a very intense debate in the current nephrology literature, with recommendations for the introduction of an age-specific limit for GFR. [ 23 24 25 26 ]…”

Section: Discussionmentioning

confidence: 99%

Serum creatinine versus corrected cockcroft-gault equation according to poggio reference values in patients with arterial hypertension

Šečić¹,

Turohan²,

Begić³

et al. 2022

Int J App Basic Med Res

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Introduction: Serum creatinine is not enough sensitive marker for the evaluation of glomerular filtration rate (GFR). Cockcroft-Gault (CG) formula is often used to assess GFR, but it is necessary to correct original one for body surface area (BSA), adipositas, and the creatinine tubular secretion. The values of the estimated creatinine clearance and GFR are considered to Poggio reference ones according to biological parameters (age and gender). The aim of the study was to determine the difference in renal function estimation between serum creatinine and corrected CG equation according to the Poggio reference values in the arterial hypertension patients. Materials and Methods: The research included 124 patients of both gender with arterial hypertension, excluding ones with the already verified chronic kidney disease. We estimated creatinine clearance and GFR by CG method corrected for the BSA, body mass index (BMI), and the creatinine tubular secretion according to Poggio reference values. Results: There was no significant difference in both age and gender groups among patients with physiological and pathological values of the renal function determined by the serum creatinine and estimated creatinine clearance by CG equation corrected for BMI, BSA. In both age and gender groups there was significant difference among subjects with physiological and pathological values of the renal function determined by serum creatinine and estimated GFR by CG method corrected for BMI, BSA, and creatinine tubular secretion. Conclusion: There is the most striking difference in the assessment of renal function between serum creatinine and estimated GFR by CG method with three corrections (BSA, BMI, the creatinine tubular secretion). Estimated GFR by CG method with three corrections can help in the early diagnosis of renal dysfunction and optimal treatment in patients with arterial hypertension.

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“…We recently described the Kidney age-Chronological age Difference (KCD) score as a means to obtain an ageadapted measure of kidney function. 12 In calculating the KCD score, an individual's kidney age is calculated from their eGFR and the age-dependent GFR decline observed in a metanalysis of 5482 healthy living potential kidney donors. 4 Thus, an individual's KCD score is the difference between their calculated kidney age and their chronological age.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…This concept of kidney age is analogous to the concept of heart age, described by D'Agostino et al 14 We showed that the KCD score provided an age-adapted measure of eGFR-associated increased risk of death or CV event in a cohort of individuals aged ≥60 years at increased CV risk. 12 A KCD score ≥20 years (KCD20) was associated with increased death or CV event risk in unadjusted analysis and after adjustment for age, sex and CV risk factors. Moreover, addition of KCD20 to a CV risk factor model improved net reclassification and integrated discrimination, and identified individuals aged <70 years who experienced death or CV event with greater sensitivity than did eGFR <60 mL/min/1.73 m 2 , with similar sensitivities for men and women.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Additional to collection of NDI data, non-fatal CV events were collected by participant interviews in 2004-2005 and in 2010-2011, and self-reported CV events: myocardial infarction (MI), stroke, coronary artery bypass graft (CABG) surgery or percutaneous transluminal coronary angioplasty (PTCA), that occurred between baseline and follow-up were adjudicated by physician review of medical records, as described by Barr et al 23 Calculation of KCD score Based on a metanalysis of 5482 healthy living potential kidney donors, 4 assuming a mean eGFR of 105 mL/ min/1.73 m 2 at age 40 years and decline of 0.9 mL/ min/1.73 m 2 per year after age 40 years for a healthy individual, an individual's kidney age in years was calculated from: [(1/0.9) × (105 − eGFR)] + 40. 12 The KCD score was calculated from the difference between an individual's kidney age and chronological age. Given that eGFR is approximately stable at 105 mL/min/1.73 m 2 for healthy living potential kidney donors aged <40 years, 4 10 for AusDiab participants aged <40 years their chronological age was set at 40 years for the calculation of the KCD score to prevent overestimation of the KCD score in these participants.…”

Section: Open Accessmentioning

confidence: 99%

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Prediction of cardiovascular death and non-fatal cardiovascular events by the Kidney age–Chronological age Difference (KCD) score in men and women of different ages in a community-based cohort

2023

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ObjectiveWe examined the utility of the Kidney age–Chronological age Difference (KCD) score, an age-adapted measure of kidney function, to identify increased cardiovascular (CV) death or non-fatal CV event risk in participants of the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab), a community-based cohort aged 23–95 years.DesignCohort study.SettingCommunity.Participants11205 randomly selected participants from urban and nonurban areas across Australia.Outcome measuresMortality status and underlying and contributory causes of death obtained from the Australian National Death Index, and non-fatal CV events from adjudicated hospital records. The association of CV death or non-fatal CV event risk with KCD score was examined using penalised spline curve analysis.ResultsOf 11 180 participants with serum creatinine measurement at baseline and 5-year outcome data, there were 308 CV deaths or non-fatal CV events after 5 years. Penalised spline curve analysis showed similar progressive increase in CV death or non-fatal CV event risk with increasing KCD score in men and women, and participants aged <50 years to ≥80 years. Receiver operating characteristic curve analysis showed optimal discrimination at a KCD score ≥20 years (KCD20) for all participants. Among 148 participants aged<70 years with CV death or non-fatal CV event, KCD20 identified 24 (16%) participants, whereas estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2identified 8 (5%) participants (p=0.0001), with specificities of 95% and 99%, respectively (p<0.0001).ConclusionKCD20 predicted CV death or non-fatal CV event risk similarly in men and women of different ages in this population-based cohort. The higher sensitivity for prediction of CV death or non-fatal CV event risk in participants aged <70 years by KCD20 than by eGFR <60 mL/min/1.73 m2offers opportunity for earlier renoprotective therapy in individuals with eGFR-associated increased CV death or non-fatal CV event risk.

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Kidney age - chronological age difference (KCD) score provides an age-adapted measure of kidney function

Cited by 6 publications

References 49 publications

Anemia is a risk factor for rapid eGFR decline in type 2 diabetes

Anemia is a risk factor for rapid eGFR decline in type 2 diabetes

Serum creatinine versus corrected cockcroft-gault equation according to poggio reference values in patients with arterial hypertension

Prediction of cardiovascular death and non-fatal cardiovascular events by the Kidney age–Chronological age Difference (KCD) score in men and women of different ages in a community-based cohort

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