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Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation pronouncedly underestimates glomerular filtration rate in type 2 diabetes.

Silveiro SP, Araújo GN, Ferreira MN, Souza FD, Yamaguchi HM, Camargo EG - Diabetes Care (2011)

Bottom Line: Accuracy (95% CI) was 67% (58-74) for CKD-EPI and 64% (56-75) for MDRD.Precision was 21 and 22, respectively.CONCLUSIONS The CKD-EPI and MDRD equations pronouncedly underestimated GFR in type 2 diabetic patients.

View Article: PubMed Central - PubMed

Affiliation: Graduate PrograminMedical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil. sandrasilveiro@terra.com.br

ABSTRACT
OBJECTIVE To evaluate the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate (GFR) in type 2 diabetic patients with GFR >60 mL/min/1.73 m(2). RESEARCH DESIGN AND METHODS This was a cross-sectional study including 105 type 2 diabetic patients. GFR was measured by (51)Cr-EDTA method and estimated by the MDRD and CKD-EPI equations. Serum creatinine was measured by the traceable Jaffe method. Bland-Altman plots were used. Bias, accuracy (P30), and precision were evaluated. RESULTS The mean age of patients was 57 ± 8 years; 53 (50%) were men and 90 (86%) were white. Forty-six (44%) patients had microalbuminuria, and 14 (13%) had macroalbuminuria. (51)Cr-EDTA GFR was 103 ± 23, CKD-EPI GFR was 83 ± 15, and MDRD-GFR was 78 ± 17 mL/min/1.73 m² (P < 0.001). Accuracy (95% CI) was 67% (58-74) for CKD-EPI and 64% (56-75) for MDRD. Precision was 21 and 22, respectively. CONCLUSIONS The CKD-EPI and MDRD equations pronouncedly underestimated GFR in type 2 diabetic patients.

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Plots of average estimated and measured GFR vs. difference between them in the 105 patients with type 2 diabetes for MDRD (A) and CKD-EPI (B) equations (P < 0.001 for all comparisons). Limits of agreement, calculated as bias ± 2 SD (CI) as follows: CKD-EPI −21 (−28 to −14) to 61 (54–68) mL/min/1.73 m2, and MDRD −18 (−26 to −11) to 67 (60–74) mL/min/1.73 m2.
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Figure 1: Plots of average estimated and measured GFR vs. difference between them in the 105 patients with type 2 diabetes for MDRD (A) and CKD-EPI (B) equations (P < 0.001 for all comparisons). Limits of agreement, calculated as bias ± 2 SD (CI) as follows: CKD-EPI −21 (−28 to −14) to 61 (54–68) mL/min/1.73 m2, and MDRD −18 (−26 to −11) to 67 (60–74) mL/min/1.73 m2.

Mentions: Figure 1 shows the plots of measured and estimated GFR values. The CKD-EPI and MDRD equations systematically underestimated measured GFR. Bias was 20 and 24 mL/min/1.73 m2 for CKD-EPI and MDRD, respectively (P = 0.26). Bias was significantly greater in subjects with GFR above versus below the median value (30 vs. 9 for CKD-EPI and 34 vs. 14 mL/min/1.73 m2 for MDRD [P < 0.001 for each pair of comparisons]). Accuracy P30 (95% CI) was 67% (58–74) for CKD-EPI and 64% (56–75) for MDRD. Precision was 21 and 22, respectively.


Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation pronouncedly underestimates glomerular filtration rate in type 2 diabetes.

Silveiro SP, Araújo GN, Ferreira MN, Souza FD, Yamaguchi HM, Camargo EG - Diabetes Care (2011)

Plots of average estimated and measured GFR vs. difference between them in the 105 patients with type 2 diabetes for MDRD (A) and CKD-EPI (B) equations (P < 0.001 for all comparisons). Limits of agreement, calculated as bias ± 2 SD (CI) as follows: CKD-EPI −21 (−28 to −14) to 61 (54–68) mL/min/1.73 m2, and MDRD −18 (−26 to −11) to 67 (60–74) mL/min/1.73 m2.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198274&req=5

Figure 1: Plots of average estimated and measured GFR vs. difference between them in the 105 patients with type 2 diabetes for MDRD (A) and CKD-EPI (B) equations (P < 0.001 for all comparisons). Limits of agreement, calculated as bias ± 2 SD (CI) as follows: CKD-EPI −21 (−28 to −14) to 61 (54–68) mL/min/1.73 m2, and MDRD −18 (−26 to −11) to 67 (60–74) mL/min/1.73 m2.
Mentions: Figure 1 shows the plots of measured and estimated GFR values. The CKD-EPI and MDRD equations systematically underestimated measured GFR. Bias was 20 and 24 mL/min/1.73 m2 for CKD-EPI and MDRD, respectively (P = 0.26). Bias was significantly greater in subjects with GFR above versus below the median value (30 vs. 9 for CKD-EPI and 34 vs. 14 mL/min/1.73 m2 for MDRD [P < 0.001 for each pair of comparisons]). Accuracy P30 (95% CI) was 67% (58–74) for CKD-EPI and 64% (56–75) for MDRD. Precision was 21 and 22, respectively.

Bottom Line: Accuracy (95% CI) was 67% (58-74) for CKD-EPI and 64% (56-75) for MDRD.Precision was 21 and 22, respectively.CONCLUSIONS The CKD-EPI and MDRD equations pronouncedly underestimated GFR in type 2 diabetic patients.

View Article: PubMed Central - PubMed

Affiliation: Graduate PrograminMedical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil. sandrasilveiro@terra.com.br

ABSTRACT
OBJECTIVE To evaluate the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate (GFR) in type 2 diabetic patients with GFR >60 mL/min/1.73 m(2). RESEARCH DESIGN AND METHODS This was a cross-sectional study including 105 type 2 diabetic patients. GFR was measured by (51)Cr-EDTA method and estimated by the MDRD and CKD-EPI equations. Serum creatinine was measured by the traceable Jaffe method. Bland-Altman plots were used. Bias, accuracy (P30), and precision were evaluated. RESULTS The mean age of patients was 57 ± 8 years; 53 (50%) were men and 90 (86%) were white. Forty-six (44%) patients had microalbuminuria, and 14 (13%) had macroalbuminuria. (51)Cr-EDTA GFR was 103 ± 23, CKD-EPI GFR was 83 ± 15, and MDRD-GFR was 78 ± 17 mL/min/1.73 m² (P < 0.001). Accuracy (95% CI) was 67% (58-74) for CKD-EPI and 64% (56-75) for MDRD. Precision was 21 and 22, respectively. CONCLUSIONS The CKD-EPI and MDRD equations pronouncedly underestimated GFR in type 2 diabetic patients.

Show MeSH
Related in: MedlinePlus