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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.


Evaluation of normalization ability. The indices for BMI strata are plotted as estimated values with 95% CI. BMI = body mass index, CI = confidence interval.
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Figure 2: Evaluation of normalization ability. The indices for BMI strata are plotted as estimated values with 95% CI. BMI = body mass index, CI = confidence interval.

Mentions: In the 1st population, the indices for evaluating normalization ability are plotted on Figure 2. In each stratum, the normalization ability of W-A was better than that of BSA. However, stratum B was different from other strata in that both BSA and W-A normalization was not obviously better than no normalization. The Passing&Bablok regression indicated that the systematic differences between gGFR and pGFR of stratum B was higher (−13.82 mL/min) than that of the stratum A or C (−3.73 and −0.85 mL/min, respectively). The same results were also found in other populations (see Supplemental Figures 2 and 4, Supplemental Content, which illustrates the same results in the 2nd and 3rd populations). Therefore, the increased systematic difference of the stratum B covered the obvious changes of random variation eliminated by normalization.5


Influence of Weight-Age Normalization on Glomerular Filtration Rate Values of Renal Patients
Evaluation of normalization ability. The indices for BMI strata are plotted as estimated values with 95% CI. BMI = body mass index, CI = confidence interval.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Evaluation of normalization ability. The indices for BMI strata are plotted as estimated values with 95% CI. BMI = body mass index, CI = confidence interval.
Mentions: In the 1st population, the indices for evaluating normalization ability are plotted on Figure 2. In each stratum, the normalization ability of W-A was better than that of BSA. However, stratum B was different from other strata in that both BSA and W-A normalization was not obviously better than no normalization. The Passing&Bablok regression indicated that the systematic differences between gGFR and pGFR of stratum B was higher (−13.82 mL/min) than that of the stratum A or C (−3.73 and −0.85 mL/min, respectively). The same results were also found in other populations (see Supplemental Figures 2 and 4, Supplemental Content, which illustrates the same results in the 2nd and 3rd populations). Therefore, the increased systematic difference of the stratum B covered the obvious changes of random variation eliminated by normalization.5

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.