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

Abstract

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.

Generation of a New Cystatin C–Based Estimating Equation for Glomerular Filtration Rate by Use of 7 Assays Standardized to the International Calibrator

“…Linear regression with 1/mGFR as regression weights was used to increase the importance of patients with low GFR (11 ). The regression equation above corresponds to an eGFR equation of the following form:…”

The shrunken pore syndrome is associated with declined right ventricular systolic function in a heart failure population – the HARVEST study

“…The analyses were performed during November 2015. Plasma creatinine was measured using an enzymatic colorimetric assay with an IDMS-traceable calibrator on the Hitachi Modular P analysis system 6 (Roche, Basel, Switzerland) [13]. The total analytical imprecision was 3.0% (with a concentration of 60 µmol/L in control sample) and 1.4% (with a concentration of 578 µmol/L in control sample; normal reference range: 60-100 µmol/L for men and 50-90 µmol/L for women).…”

“…So were the LMrev [13] and CKD-EPIcreatinine [15] estimating equations based on creatinine. The best estimate of GFR is the mean of eGFRcystatin C and of eGFRcreatinine (eGFRmean) and this is true also when eGFRcystatin C and eGFRcreatinine differ significantly [13,[15][16][17][18]. We used the eGFRmean to describe the renal function in the whole cohort.…”

Combining Cystatin C and Creatinine Yields a Reliable Glomerular Filtration Rate Estimation in Older Adults in Contrast to β-Trace Protein and β2-Microglobulin

“…The studies that have been done in adults over 70 years of age from the general population have examined creatinine and cystatin C with focus on the CKDEpidemiology collaboration (CKD-EPI), Modification of Diet in Renal Disease study (MDRD), and Berlin Initiative Study (BIS) equations, with some studies including other equations [12][13][14][15][16][17][18] . These equations have been compared to Lund-Malmö Revised (LM-REV) [19] , CaucasianAsian-Pediatric-Adult (CAPA) and the mean of the latter 2 in an older population in a clinical setting [20,21] . Further validation studies of these equations in external populations will improve their generalisability.…”