BACKGROUND: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals. METHODS: This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by the 51Cr-EDTA single-injection method (51Cr-GFR). Accuracy (P30), bias, and Bland-Altman agreement plots were evaluated. RESULTS: In the group as a whole, 51Cr-GFR was 87±37 (6-187), CKD-EPI eGFR, 82±30 (6-152), and MDRD eGFR, 77±28 (6-156) mL/min/1.73 m2 (p<0.001 for all comparisons). Analyzing the subset of individuals with 51Cr-GFR <60 mL/min/1.73 m2, P30 values were, respectively, 76% and 84% for MDRD and for CKD-EPI (p<0.001) while for 51Cr-GFR ≥60 mL/min/1.73 m2, P30 values were 57.5% for both equations (p=1.000). For MDRD and CKD-EPI, mean bias were negative for GFRs <60 (-11 vs. -12, p=0.221) and positive for values >60 (16 vs. 9, p<0.001). In multivariate analysis, absolute bias was unfavorably influenced by measured GFR >60 (for MDRD) and being diabetic or younger (for CKD-EPI). CONCLUSIONS: CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m2. CKD stages 1 and 2, diabetes and young age had a negative influence on the performance of the equations.
BACKGROUND: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals. METHODS: This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by the 51Cr-EDTA single-injection method (51Cr-GFR). Accuracy (P30), bias, and Bland-Altman agreement plots were evaluated. RESULTS: In the group as a whole, 51Cr-GFR was 87±37 (6-187), CKD-EPI eGFR, 82±30 (6-152), and MDRD eGFR, 77±28 (6-156) mL/min/1.73 m2 (p<0.001 for all comparisons). Analyzing the subset of individuals with 51Cr-GFR <60 mL/min/1.73 m2, P30 values were, respectively, 76% and 84% for MDRD and for CKD-EPI (p<0.001) while for 51Cr-GFR ≥60 mL/min/1.73 m2, P30 values were 57.5% for both equations (p=1.000). For MDRD and CKD-EPI, mean bias were negative for GFRs <60 (-11 vs. -12, p=0.221) and positive for values >60 (16 vs. 9, p<0.001). In multivariate analysis, absolute bias was unfavorably influenced by measured GFR >60 (for MDRD) and being diabetic or younger (for CKD-EPI). CONCLUSIONS: CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m2. CKD stages 1 and 2, diabetes and young age had a negative influence on the performance of the equations.
Authors: Érique José F Peixoto de Miranda; Márcio Sommer Bittencourt; Alessandra C Goulart; Itamar S Santos; Silvia Maria de Oliveira Titan; Roberto Marini Ladeira; Sandhi Maria Barreto; Paulo A Lotufo; Isabela Judith Martins Benseñor Journal: Clin Exp Nephrol Date: 2017-03-27 Impact factor: 2.801
Authors: Marcelo P Baldo; Luisa C C Brant; Roberto S Cunha; Maria Del Carmen B Molina; Rosane H Griep; Sandhi M Barreto; Paulo Andrade Lotufo; Isabela M Bensenor; José G Mill Journal: J Clin Hypertens (Greenwich) Date: 2019-11-19 Impact factor: 3.738
Authors: Marcelo P Baldo; Roberto S Cunha; Antônio L P Ribeiro; Paulo A Lotufo; Dora Chor; Sandhi M Barreto; Isabela M Bensenor; Alexandre C Pereira; José Geraldo Mill Journal: J Am Heart Assoc Date: 2017-06-21 Impact factor: 5.501
Authors: Jordana Herzog Siqueira; José Geraldo Mill; Gustavo Velasquez-Melendez; Alexandra Dias Moreira; Sandhi Maria Barreto; Isabela Martins Benseñor; Maria Del Carmen Bisi Molina Journal: Nutrients Date: 2018-07-27 Impact factor: 5.717
Authors: João Victor Marques Guedes; Jéssica Azevedo Aquino; Tássia Lima Bernardino Castro; Flávio Augusto de Morais; André Oliveira Baldoni; Vinícius Silva Belo; Alba Otoni Journal: PLoS One Date: 2020-03-04 Impact factor: 3.240