The new Asian modified CKD-EPI equation leads to more accurate GFR estimation in Chinese patients with CKD

Wang, Jinghua; Xie, Peng; Huang, Jianmin; Qü, Yan; Zhang, Fang; Wei, Lingge; Fu, Ping; Huang, Xinnan

doi:10.1007/s11255-016-1386-9

Cited by 48 publications

(44 citation statements)

References 29 publications

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“…We compared these studies mentioned above, the inconsistent results may come from the following: (1) the research population is different. These studies, which were inconsistent with our findings, were targeted at Israel and America,(2) many of these different conclusions do not clarify the nonlinear relationship and use different regression In the present study, we found using two-piecewise linear regression model to show a nonlinear relation is different to that obtained by Lorenzo et al [7].In their study, they used subgroup analysis stratified by GFR categories to assess a U shape relation between eGFR and risk of T2DM, they used CKD-EPI equation [8] to estimate GFR, which could lead to more accurate GFR estimation in Chinese patients with CKD in general practice, especially in the higher GFR group. Because of the participants in our study was all with eGFR above 60 ml/min/1.73m 2 .…”

Section: Discussioncontrasting

confidence: 63%

“…This website 107 Aspartate aminotransferase(AST), smoking status, drinking status, family history of diabetes, year of follow up and censor of diabetes during follow up. In our research, we added evaluated glomerular filtration rate(eGFR), which was calculated based on age, gender and Scr according to CKD-EPI equation [8]. This new Asian modified CKD-EPI equation could lead to more accurate GFR estimation in Chinese patients with CKD in general practice, especially in the higher GFR group.…”

Section: Data Source and Participants 106mentioning

confidence: 99%

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Association of evaluated glomerular filtration rate and incident diabetes mellitus: a secondary retrospective analysis based on a Chinese Cohort Study

Guan

Chen

et al. 2020

Preprint

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Background: Previous studies have revealed that chronic kidney disease (CKD) is one of major risk factors of insulin resistance and diabetes. However, there are few investigations of the correlations between the estimated glomerular filtration rate (eGFR) and incident diabetes, especially in Chinese population. This study was taken to explore the relationship between eGFR and incident diabetes in a large cohort in Chinese community population. Methods: The present study was a retrospective cohort study. A total of 199,435 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were eGFR measured at baseline and incident diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association between eGFR and incident diabetes. Generalized additive model was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website. Result: After adjusting gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, smoking and drinking status and family history of diabetes, result showed eGFR was negatively associated with incident diabetes (HR=0.987, 95%CI (0.984, 0.989)). A J shape relationship was detected between eGFR and incident diabetes, which had an inflection point of eGFR was 97.967 mL/min-1·(1.73 m2)-1. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.999 (0.994,1.004) and 0.977 (0.974,0.981), respectively. Subgroup analysis showed, the stronger association can be found in the population with FPG<6.1mmol/L, BMI<24kg/m2, SBP<140mmHg, DBP<90mmHg, HDL in middle level and family history without diabetes. The same trend was also seen in men and in the population with never or ever smoking. Conclusion: eGFR is independently associated with incident diabetes. The relationship between eGFR and incident diabetes is also non-linear. eGFR was strong negatively related to incident diabetes when eGFR is above 97.967 mL/min-1·(1.73 m2)-1.

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Section: Discussioncontrasting

confidence: 63%

Section: Data Source and Participants 106mentioning

confidence: 99%

Association of evaluated glomerular filtration rate and incident diabetes mellitus: a secondary retrospective analysis based on a Chinese Cohort Study

Guan

Chen

et al. 2020

Preprint

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“…The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in the KSH study was developed based on Whites and Blacks, and it was later shown to introduce inaccuracies when estimating GFR in Asians [23][24][25]. In our study, we used the CMDRD equation to estimate GFR, which improved the accuracy and performance of GFR estimation in a Chinese population [26]. The mechanisms underlying the association between the serum levels of TSH and FT3 and eGFR in euthyroid individuals remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Association of Thyroid Function With the Estimated Glomerular Filtration Rate in a Large Chinese Euthyroid Population

Wang¹,

Xie

Gu³

et al. 2018

Kidney Blood Press Res

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Background/Aims: We aimed to explore whether thyroid function within a normal range is associated with the estimated glomerular filtration rate (eGFR) and the incidence of chronic kidney disease (CKD) in a large Chinese population. Methods: We conducted a cross-sectional study that included 10,859 euthyroid individuals who underwent an annual regular health checkup in Jiangsu Province Official Hospital between August 2012 and August 2013. We measured the thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels using a Roche modular analytics E170 and then calculated the eGFR using the Chinese modified Modification of Diet in Renal Disease (CMDRD) equation. Results: In multiple linear regression models, TSH was negatively associated with eGFR after adjusting for confounding factors (β = -0.072, P = 1.994×10^-22). The significance remained in both males and females. No significant association was observed between FT4 and eGFR. In the logistic regression model, we did not observe significant associations of TSH or FT3 with CKD. Participants in the highest quartile of FT4 versus the lowest quartile (reference) had an increased risk of CKD (OR = 1.763, P = 0.012). The risk of CKD was more pronounced in females with the highest quartile of FT4 (OR = 2.424, P = 0.029). Conclusion: Our findings suggest that TSH is associated with eGFR in euthyroid individuals and that higher FT4 is associated with an increased risk of CKD. More cohort studies are warranted to confirm whether the association is causal.

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“…The demographic and clinical parameters of patients, including age, gender, blood pressure (BP), urinary red blood cells count, serum creatinine (SCr), urine creatinine (UCr) and 24-hour urinary protein excretion (24hUPro) were obtained immediately before renal biopsy. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation [31]. Pathological features were evaluated according to updated Oxford classification [32] and Lee grading [33], which were graded by a pathologist blinded to patients' clinical data.…”

Section: Clinical and Pathological Manifestationsmentioning

confidence: 99%

“…Data are present as mean±SD or median (interquartile range) , or frequency in percent. equation [31] b Determined in accordance with the Oxford classification [32] Figures Figure 1 The levels of urinary joining chain containing IgG immune complexes/creatinine ratio and IgA-IgG immune complexes/creatinine ratio (OD450nm/mmol/L Cr) in patients with IgA nephropathy, patients with other kidney diseases and healthy subjects. The levels of (a) UJGCR and (b) UAGCR were significantly higher in IgAN group than HC group and DC group.…”

Section: Availability Of Data and Materialsmentioning

confidence: 99%

The levels of urinary joining chain containing IgG immune complexes are associated with disease severity in IgA nephropathy

Cai

Fan

et al. 2019

Preprint

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Background: Circulating levels of aberrantly glycosylated IgA1 and its immune complexes (IgA/IgG-IC) are elevated and correlated with disease severity in IgA nephropathy (IgAN). The pathologic IgA containing immune complexes deposits in the kidney were found to be in dimeric or polymeric forms, suggesting that those deposited IgA immune complexes contain joining chain, which is critical for the multimerization and transportation of IgA. Both the dimeric IgA and polymeric IgA can cause renal damage by inducing the release of cytokines from mesangial cells. We aimed to investigate the urinary J chain containing IgG immune complexes/creatinine ratio (UJGCR) and analyze its relationship with disease severity in IgAN. Methods: The UJGCR were measured by sandwich enzyme linked immunosorbent assay in 26 patients with IgAN, 31 patients with other kidney diseases and 32 healthy volunteers. Results: The levels of UJGCR were higher in patients with IgAN than that in non-IgAN patients ( P =0.006) and healthy volunteers ( P <0.0001). Importantly, receiver operating characteristics curve analysis confirmed that UJGCR had good discrimination between non-IgAN patients and IgAN patients. The levels of UJGCR positively correlated with 24-hour urinary protein excretion (r=0.63, P =0.0006), serum creatinine (r=0.55, P =0.003), and negatively correlated with estimated glomerular filtration rate (r= -0.61, P =0.0008) in IgAN. Furthermore, the levels of UJGCR were higher in IgAN patients with IgA mesangial deposition of (+/++) than patients with (+++/++++). And IgAN patients with tubular atrophy/interstitial fibrosis showed higher levels of UJGCR than that without ( P =0.03). Similarly, the levels of urinary IgA-IgG/creatinine ratio (UAGCR) were also found to be elevated and associated with clinical and pathological parameters as UJGCR in IgAN. Besides, significant correlation between the levels of UJGCR and UAGCR was shown, suggesting UJGCR was mainly composed of J-IgA-IgG. Conclusions: The levels of UJGCR are associated with disease severity in IgAN. UJGCR is a potential biomarker for both glomerular and tubulointerstitial lesions in IgAN.

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The new Asian modified CKD-EPI equation leads to more accurate GFR estimation in Chinese patients with CKD

Abstract: The new Asian modified CKD-EPI equation can lead to more accurate GFR estimation in Chinese patients with CKD in general practice, especially in the higher GFR group.

Cited by 48 publications

References 29 publications

Association of evaluated glomerular filtration rate and incident diabetes mellitus: a secondary retrospective analysis based on a Chinese Cohort Study

Association of evaluated glomerular filtration rate and incident diabetes mellitus: a secondary retrospective analysis based on a Chinese Cohort Study

Association of Thyroid Function With the Estimated Glomerular Filtration Rate in a Large Chinese Euthyroid Population

The levels of urinary joining chain containing IgG immune complexes are associated with disease severity in IgA nephropathy

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