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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.


Influence of normalization on GFR values. From the first to the third row, plots are for the difference of paired GFRs, the difference of pGFR before and after normalization, and the difference of gGFR before and after normalization, respectively. Median bias is plotted as estimated value with 95% CI, and IQR and RMSE are plotted as the calculated value only. CI = confidence interval, GFR = glomerular filtration rate, gGFR = camera-based glomerular filtration rate, IQR = interquartile range, pGFR = plasma clearance glomerular filtration rate, RMSE = root-mean square error.
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Figure 3: Influence of normalization on GFR values. From the first to the third row, plots are for the difference of paired GFRs, the difference of pGFR before and after normalization, and the difference of gGFR before and after normalization, respectively. Median bias is plotted as estimated value with 95% CI, and IQR and RMSE are plotted as the calculated value only. CI = confidence interval, GFR = glomerular filtration rate, gGFR = camera-based glomerular filtration rate, IQR = interquartile range, pGFR = plasma clearance glomerular filtration rate, RMSE = root-mean square error.

Mentions: The differences between any 2 of the unscaled, BSA scaled, and W-A scaled gGFR (or pGFR) were not obviously changed (Figure 3). In general, interquartile range, bias, and root-mean square error of W-A scaled pGFR (or gGFR) were slightly larger than that of BSA scaled and unscaled pGFR (or gGFR) consequently. However, the median bias between BSA scaled GFRs could even decrease by W-A normalization from 1.00 to 0.86 mL/min in the stratum A, and from 4.37 to 3.81 mL/min in the stratum C.


Influence of Weight-Age Normalization on Glomerular Filtration Rate Values of Renal Patients
Influence of normalization on GFR values. From the first to the third row, plots are for the difference of paired GFRs, the difference of pGFR before and after normalization, and the difference of gGFR before and after normalization, respectively. Median bias is plotted as estimated value with 95% CI, and IQR and RMSE are plotted as the calculated value only. CI = confidence interval, GFR = glomerular filtration rate, gGFR = camera-based glomerular filtration rate, IQR = interquartile range, pGFR = plasma clearance glomerular filtration rate, RMSE = root-mean square error.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Influence of normalization on GFR values. From the first to the third row, plots are for the difference of paired GFRs, the difference of pGFR before and after normalization, and the difference of gGFR before and after normalization, respectively. Median bias is plotted as estimated value with 95% CI, and IQR and RMSE are plotted as the calculated value only. CI = confidence interval, GFR = glomerular filtration rate, gGFR = camera-based glomerular filtration rate, IQR = interquartile range, pGFR = plasma clearance glomerular filtration rate, RMSE = root-mean square error.
Mentions: The differences between any 2 of the unscaled, BSA scaled, and W-A scaled gGFR (or pGFR) were not obviously changed (Figure 3). In general, interquartile range, bias, and root-mean square error of W-A scaled pGFR (or gGFR) were slightly larger than that of BSA scaled and unscaled pGFR (or gGFR) consequently. However, the median bias between BSA scaled GFRs could even decrease by W-A normalization from 1.00 to 0.86 mL/min in the stratum A, and from 4.37 to 3.81 mL/min in the stratum C.

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.