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Influence of Weight-Age Normalization on Glomerular Filtration Rate Values of Renal Patients

View Article: PubMed Central - PubMed

ABSTRACT

To explore whether weight-age (W-A) could be applied in clinical practice, this study was designed to verify the normalization ability of W-A by the data from another medical center, and to access the influence of the normalization on glomerular filtration rate (GFR) values in renal patients.

Both plasma clearance (pGFR) and camera-based (gGFR), which were separately scaled to W-A and body surface area (BSA), were measured for patients with diffuse renal diseases. The patients (n = 298) were stratified according to the Chinese body mass index (BMI) criteria and were staged according to the Kidney Disease Outcome Quality Initiatives guideline based on gGFR and pGFR separately.

The indices of intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC), and ratio of residual standard deviation to pooled standard deviation (RSD/PSD) suggested that, for all patients and each BMI stratum, W-A was obviously better than BSA in scaling GFR. Both under pGFR or gGFR renal stages, only small amount of the patients encountered stage migrations from BSA to W-A scaled stages. The differences between any 2 of the unscaled, BSA scaled, and W-A scaled gGFR (or pGFR) were not obviously changed. Additionally, in some strata, W-A normalization is better than BSA normalization in decreasing the median bias between pGFR and gGFR.

W-A is better than BSA in scaling GFR without obvious modifying GFR values and can be applied in routine clinical practice.

No MeSH data available.


Related in: MedlinePlus

Bland–Altman plots for paired GFRs (mL/min). From the top to the bottom, the plots are for unscaled, BSA and W-A scaled GFRs, respectively. The x-axis and y-axis represent the mean and difference between paired GFRs, respectively. The full line is the mean difference, and the area between the broken lines is the 95% confidence interval. BSA = body surface area, GFR = glomerular filtration rate, W-A = weight-age.
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Figure 1: Bland–Altman plots for paired GFRs (mL/min). From the top to the bottom, the plots are for unscaled, BSA and W-A scaled GFRs, respectively. The x-axis and y-axis represent the mean and difference between paired GFRs, respectively. The full line is the mean difference, and the area between the broken lines is the 95% confidence interval. BSA = body surface area, GFR = glomerular filtration rate, W-A = weight-age.

Mentions: In the 1st population, there was significant difference between unscaled gGFR and unscaled pGFR (t = 2.043, P = 0.042). BSA normalization could not eliminate the significance (t = 2.073, P = 0.039), but W-A normalization could (t = 1.865, P = 0.063). The Bland–Altman plots (Figure 1) indicated that both W-A and BSA normalization could slightly enlarge the 95% limits of agreement. On Figure 1, the mean difference between W-A scaled gGFR and pGFR is even smaller than that of unscaled or BSA scaled (see Supplemental Figures 1 and 3, Supplemental Content, which illustrates the similar results of the 2nd and 3rd populations).


Influence of Weight-Age Normalization on Glomerular Filtration Rate Values of Renal Patients
Bland–Altman plots for paired GFRs (mL/min). From the top to the bottom, the plots are for unscaled, BSA and W-A scaled GFRs, respectively. The x-axis and y-axis represent the mean and difference between paired GFRs, respectively. The full line is the mean difference, and the area between the broken lines is the 95% confidence interval. BSA = body surface area, GFR = glomerular filtration rate, W-A = weight-age.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998260&req=5

Figure 1: Bland–Altman plots for paired GFRs (mL/min). From the top to the bottom, the plots are for unscaled, BSA and W-A scaled GFRs, respectively. The x-axis and y-axis represent the mean and difference between paired GFRs, respectively. The full line is the mean difference, and the area between the broken lines is the 95% confidence interval. BSA = body surface area, GFR = glomerular filtration rate, W-A = weight-age.
Mentions: In the 1st population, there was significant difference between unscaled gGFR and unscaled pGFR (t = 2.043, P = 0.042). BSA normalization could not eliminate the significance (t = 2.073, P = 0.039), but W-A normalization could (t = 1.865, P = 0.063). The Bland–Altman plots (Figure 1) indicated that both W-A and BSA normalization could slightly enlarge the 95% limits of agreement. On Figure 1, the mean difference between W-A scaled gGFR and pGFR is even smaller than that of unscaled or BSA scaled (see Supplemental Figures 1 and 3, Supplemental Content, which illustrates the similar results of the 2nd and 3rd populations).

View Article: PubMed Central - PubMed

ABSTRACT

To explore whether weight-age (W-A) could be applied in clinical practice, this study was designed to verify the normalization ability of W-A by the data from another medical center, and to access the influence of the normalization on glomerular filtration rate (GFR) values in renal patients.

Both plasma clearance (pGFR) and camera-based (gGFR), which were separately scaled to W-A and body surface area (BSA), were measured for patients with diffuse renal diseases. The patients (n = 298) were stratified according to the Chinese body mass index (BMI) criteria and were staged according to the Kidney Disease Outcome Quality Initiatives guideline based on gGFR and pGFR separately.

The indices of intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC), and ratio of residual standard deviation to pooled standard deviation (RSD/PSD) suggested that, for all patients and each BMI stratum, W-A was obviously better than BSA in scaling GFR. Both under pGFR or gGFR renal stages, only small amount of the patients encountered stage migrations from BSA to W-A scaled stages. The differences between any 2 of the unscaled, BSA scaled, and W-A scaled gGFR (or pGFR) were not obviously changed. Additionally, in some strata, W-A normalization is better than BSA normalization in decreasing the median bias between pGFR and gGFR.

W-A is better than BSA in scaling GFR without obvious modifying GFR values and can be applied in routine clinical practice.

No MeSH data available.


Related in: MedlinePlus