Staging chronic kidney disease and estimating glomerular filtration rate: an opinion paper about the new international recommendations

Delanaye, Pierre; Cavalier, Étienne

doi:10.1515/cclm-2013-0223

Cited by 15 publications

(9 citation statements)

References 67 publications

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“…Nevertheless, our results indicate that all assays are not equivalent. Surprisingly, little attention has been paid to this question in a recent KDIGO conferences report [10,15]. Our results are in line with previous studies concluding that compensated Jaffe assays should be replaced by enzymatic ones [9,16].…”

Section: Discussionsupporting

confidence: 90%

Enzymatic creatinine assays allow estimation of glomerular filtration rate in stages 1 and 2 chronic kidney disease using CKD-EPI equation

Kuster

Cristol

Cavalier

et al. 2014

Clinica Chimica Acta

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The National Kidney Disease Education Program group demonstrated that MDRD equation is sensitive to creatinine measurement error, particularly at higher glomerular filtration rates. Thus, MDRD-based eGFR above 60 mL/min/1.73 m 2 should not be reported numerically. However, little is known about the impact of analytical error on CKD-EPI-based estimates. This study aimed at assessing the impact of analytical characteristics (bias and imprecision) of 12 enzymatic and 4 compensated Jaffe previously characterized creatinine assays on MDRD and CKD-EPI eGFR. In a simulation study, the impact of analytical error was assessed on a hospital population of 24 084 patients. Ability using each assay to correctly classify patients according to chronic kidney disease (CKD) stages was evaluated.For eGFR between 60 and 90 mL/min/1.73 m 2 , both equations were sensitive to analytical error. Compensated Jaffe assays displayed high bias in this range and led to poorer sensitivity/specificity for classification according to CKD stages than enzymatic assays. As compared to MDRD equation, CKD-EPI equation decreases impact of analytical error in creatinine measurement above 90 mL/min/1.73 m 2 . Compensated Jaffe creatinine assays lead to important errors in eGFR and should be avoided. Accurate enzymatic assays allow estimation of eGFR until 90 mL/min/1.73 m 2 with MDRD and 120 mL/min/1.73 m 2 with CKD-EPI equation.

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Section: Discussionsupporting

confidence: 90%

Enzymatic creatinine assays allow estimation of glomerular filtration rate in stages 1 and 2 chronic kidney disease using CKD-EPI equation

Kuster

Cristol

Cavalier

et al. 2014

Clinica Chimica Acta

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“…Differences in creatinine calibrations between North America and Europe cannot be ruled out as an explanation for the transatlantic differences in performance of MDRD and CKD-EPI. Both the MDRD and CKD-EPI equations have been developed from plasma creatinine samples measured mostly with the Jaffe assay, i.e., non-enzymatic methods, and traceability to IDMS standard has been obtained indirectly or a posteriori [32]. It should also be noted that the North American equations were established using renal clearance of iothalamate as reference, whereas single sample of plasma clearance of iohexol was used when LM Revised was developed.…”

Section: Results In Relation To Previous Studiesmentioning

confidence: 99%

The revised Lund-Malmö GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population

Nyman

Grubb

Larsson

et al. 2014

Clinical Chemistry and Laboratory Medicine (CCLM)

159

147

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The revised Lund-Malmo GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish populationNyman, Ulf; Grubb, Anders; Larsson, Anders; Hansson, Lars-Olof; Flodin, Mats; Nordin, Gunnar; Lindstrom, Veronica; Björk, Jonas General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Results:The overall results of LM Revised/MDRD/ CKD-EPI were: median bias 2%/8%/11%, IQR 12/14/14 mL/min/1.73 m 2 , P 10 40%/35%/35% and P 30 84%/75%/76%. LM Revised was the most stable equation in terms of bias, precision and accuracy across mGFR, age and BMI intervals irrespective of gender. MDRD and CKD-EPI overestimated mGFR in patients with decreased kidney function, young adults and elderly. All three equations overestimated mGFR and had low accuracy in patients with BMI < 20 kg/m 2 , most pronounced among men. Conclusions: In settings similar to the investigated cohort LM Revised should be preferred to MDRD and CKD-EPI due to its higher accuracy and more stable performance across GFR, age and BMI intervals.

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“…Ainsi, le choix de la mé thode d'é valuation du DFG (choix du marqueur, formule d'estimation, mesure du DFG) repose sur la confrontation, à l'é chelon individuel, du besoin de pré cision imposé par la situation clinique et de la pré cision attendue de chacune de ces mé thodes. Ceci s'oppose en partie aux recommandations d'utilisation qui reposent parfois sur des considé rations plus é pidé miologiques que de pré cision [8][9][10]. En effet, aujourd'hui, le choix d'une formule d'estimation du DFG n'est pas, ou n'est plus, exclusivement basé sur ses performances intrinsè ques à estimer au mieux un DFG mesuré (DFGm) par une mé thode de ré fé rence, mais aussi sur sa capacité à pré dire la mortalité ou l'arrivé e à un stade terminal de la MRC [11].…”

Section: Le Patient Au Centre Du Dé Batunclassified

“…Le même type de constatation peut être fait pour ce qui est du choix d'un seuil fixe de DFG comme dé finition de l'insuffisance ré nale chronique (60 mL/min/1,73 m 2 ). Ce seuil est en effet justifié par les mêmes arguments pré dictifs [11,16,17], alors que la diminution physiologique du DFG avec l'âge pourrait imposer une adaptation de la valeur de DFG considé ré e comme anormale en fonction de l'âge [8,9,18,19]. Ces arguments é pidé miologiques doivent cependant être reconsidé ré s en matiè re d'adaptation posologique d'un mé dicament.…”

Section: Le Patient Au Centre Du Dé Batunclassified

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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Staging chronic kidney disease and estimating glomerular filtration rate: an opinion paper about the new international recommendations

Cited by 15 publications

References 67 publications

Enzymatic creatinine assays allow estimation of glomerular filtration rate in stages 1 and 2 chronic kidney disease using CKD-EPI equation

Enzymatic creatinine assays allow estimation of glomerular filtration rate in stages 1 and 2 chronic kidney disease using CKD-EPI equation

The revised Lund-Malmö GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population

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

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