Literature DB >> 18550650

Chronic kidney disease prevalence estimates among racial/ethnic groups: the Multi-Ethnic Study of Atherosclerosis.

Holly Kramer1, Walter Palmas, Bryan Kestenbaum, Mary Cushman, Matt Allison, Brad Astor, Michael Shlipak.   

Abstract

BACKGROUND AND OBJECTIVES: Muscle mass is not a major determinant of serum cystatin C levels, and its use to estimate GFR may lead to more congruent estimates of chronic kidney disease (CKD) across gender and racial/ethnic groups. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Multi-Ethnic Study of Atherosclerosis is a population-based study of 6814 men and women who are aged 45 to 85 yr and do not have clinical cardiovascular disease. Estimated CKD prevalence, defined as an estimated GFR <60 ml/min per 1.73 m(2) body surface area, was compared using three different GFR prediction equations: The abbreviated Modification of Diet in Renal Disease (MDRD) equation and two equations based on serum cystatin C.
RESULTS: Among women, CKD prevalence estimates across the four racial/ethnic groups using the MDRD- or the cystatin C-based GFR equations, which include gender and race coefficients, varied by approximately two-fold (P < 0.0001) but were more congruent with use of a serum cystatin C-based equation without the use of coefficients (P = 0.3). CKD prevalence estimates did not differ significantly across racial/ethnic groups among men with the MDRD (P = 0.07) or cystatin C formula without coefficients (P = 0.05) but did differ significantly with the cystatin C formula, which incorporates gender and race coefficients (P = 0.006).
CONCLUSIONS: CKD prevalence estimates vary across racial/ethnic groups, and the degree of variability depends on the method used to estimate GFR, especially among women. Further research is needed to determine the accuracy and precision of GFR prediction equations in racially diverse populations.

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Year:  2008        PMID: 18550650      PMCID: PMC2518793          DOI: 10.2215/CJN.04160907

Source DB:  PubMed          Journal:  Clin J Am Soc Nephrol        ISSN: 1555-9041            Impact factor:   8.237


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