INTRODUCTION: We previously reported a modification to the Modification of Diet in Renal Disease (MDRD) Study equation for use in Japan. Recently, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) developed a new equation that is more accurate and yields a lower CKD prevalence estimate in the United States than the MDRD Study equation. We modified the CKD-EPI equation for use in Japan, compared its accuracy with the Japanese modification of the MDRD Study equation, and compared the prevalence of CKD in Japan using both equations. DESIGN: A diagnostic test study comparing the Japanese coefficient-modified CKD-EPI equation and Japanese coefficient-modified MDRD Study equation and a cross-sectional study comparing distribution of estimated glomerular filtration rate and prevalence of CKD in participants in a Japanese annual health check program. SETTING & PARTICIPANTS: 763 Japanese patients (413 for development and 350 for validation) were included. Prevalence estimates were based on 574,024 participants from the annual health check program. INDEX TEST: Japanese modification of the MDRD Study and CKD-EPI equations. REFERENCE TEST: Inulin clearance. RESULTS: The Japanese coefficient of the modified CKD-EPI equation was 0.813 (95% CI, 0.794-0.833). In the validation data set, the modified CKD-EPI equation performed better than the modified MDRD Study equation. Bias (measured GFR [mGFR] - eGFR) was 0.4 +/- 17.8 (SD) versus 1.3 +/- 19.8 mL/min/1.73 m(2) overall, respectively (P = 0.02); 7.3 +/- 20.6 versus 7.8 +/- 22.2 mL/min/1.73 m(2) for participants with mGFR >or=60 mL/min/1.73 m(2), respectively (P < 0.001); and -4.4 +/- 13.8 versus -3.3 +/- 15.6 mL/min/1.73 m(2) for participants with mGFR <60 mL/min/1.73 m(2), respectively (P = 0.5). The modified CKD-EPI equation yields a lower estimated prevalence of CKD than the modified MDRD Study equation (7.9% vs 10.0%), primarily because of a lower estimated prevalence of stage 3 (5.2% vs 7.5%). LIMITATION: Most study participants had CKD. The study population contained a limited number of participants with mGFR >or=90 mL/min/1.73 m(2). CONCLUSION: The Japanese coefficient-modified CKD-EPI equation is more accurate than the Japanese coefficient-modified MDRD Study equation and leads to a lower estimated prevalence of CKD in Japan.
INTRODUCTION: We previously reported a modification to the Modification of Diet in Renal Disease (MDRD) Study equation for use in Japan. Recently, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) developed a new equation that is more accurate and yields a lower CKD prevalence estimate in the United States than the MDRD Study equation. We modified the CKD-EPI equation for use in Japan, compared its accuracy with the Japanese modification of the MDRD Study equation, and compared the prevalence of CKD in Japan using both equations. DESIGN: A diagnostic test study comparing the Japanese coefficient-modified CKD-EPI equation and Japanese coefficient-modified MDRD Study equation and a cross-sectional study comparing distribution of estimated glomerular filtration rate and prevalence of CKD in participants in a Japanese annual health check program. SETTING & PARTICIPANTS: 763 Japanese patients (413 for development and 350 for validation) were included. Prevalence estimates were based on 574,024 participants from the annual health check program. INDEX TEST: Japanese modification of the MDRD Study and CKD-EPI equations. REFERENCE TEST: Inulin clearance. RESULTS: The Japanese coefficient of the modified CKD-EPI equation was 0.813 (95% CI, 0.794-0.833). In the validation data set, the modified CKD-EPI equation performed better than the modified MDRD Study equation. Bias (measured GFR [mGFR] - eGFR) was 0.4 +/- 17.8 (SD) versus 1.3 +/- 19.8 mL/min/1.73 m(2) overall, respectively (P = 0.02); 7.3 +/- 20.6 versus 7.8 +/- 22.2 mL/min/1.73 m(2) for participants with mGFR >or=60 mL/min/1.73 m(2), respectively (P < 0.001); and -4.4 +/- 13.8 versus -3.3 +/- 15.6 mL/min/1.73 m(2) for participants with mGFR <60 mL/min/1.73 m(2), respectively (P = 0.5). The modified CKD-EPI equation yields a lower estimated prevalence of CKD than the modified MDRD Study equation (7.9% vs 10.0%), primarily because of a lower estimated prevalence of stage 3 (5.2% vs 7.5%). LIMITATION: Most study participants had CKD. The study population contained a limited number of participants with mGFR >or=90 mL/min/1.73 m(2). CONCLUSION: The Japanese coefficient-modified CKD-EPI equation is more accurate than the Japanese coefficient-modified MDRD Study equation and leads to a lower estimated prevalence of CKD in Japan.
Authors: Auni Juutilainen; Helena Kastarinen; Riitta Antikainen; Markku Peltonen; Veikko Salomaa; Jaakko Tuomilehto; Pekka Jousilahti; Jouko Sundvall; Tiina Laatikainen; Mika Kastarinen Journal: Eur J Epidemiol Date: 2012-04 Impact factor: 8.082
Authors: Vicente E Torres; Eiji Higashihara; Olivier Devuyst; Arlene B Chapman; Ronald T Gansevoort; Jared J Grantham; Ronald D Perrone; John Ouyang; Jaime D Blais; Frank S Czerwiec Journal: Clin J Am Soc Nephrol Date: 2016-02-23 Impact factor: 8.237
Authors: Nawar M Shara; Hong Wang; Mihriye Mete; Yaman Rai Al-Balha; Nameer Azalddin; Elisa T Lee; Nora Franceschini; Stacey E Jolly; Barbara V Howard; Jason G Umans Journal: Am J Kidney Dis Date: 2012-07-25 Impact factor: 8.860