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A new tool for predicting the probability of chronic kidney disease from a specific value of estimated GFR.

Björk, Jonas LU ; Grubb, Anders LU ; Sterner, Gunnar LU and Nyman, Ulf LU (2010) In Scandinavian Journal of Clinical and Laboratory Investigation Jul 1. p.327-333
Abstract
Abstract Objective. To demonstrate how patients' probability of having chronic kidney disease (CKD) stage 3-5 (measured GFR <60 mL/min/1.73 m(2)) can be predicted from a specific value of estimated glomerular filtration rate (eGFR). Material and methods. The probability of CKD stage 3-5 was predicted from a logistic regression model (n = 850) using three different eGFR prediction equations: Lund-Malmö, MDRD and CKD-EPI. Population weighting was used to illustrate how this probability varies in three different populations: original sample (55% true prevalence of CKD stage 3-5), a screening (6.7% prevalence) and a CKD population (84% prevalence). Results. All three eGFR-equations had high classification ability (area under the... (More)
Abstract Objective. To demonstrate how patients' probability of having chronic kidney disease (CKD) stage 3-5 (measured GFR <60 mL/min/1.73 m(2)) can be predicted from a specific value of estimated glomerular filtration rate (eGFR). Material and methods. The probability of CKD stage 3-5 was predicted from a logistic regression model (n = 850) using three different eGFR prediction equations: Lund-Malmö, MDRD and CKD-EPI. Population weighting was used to illustrate how this probability varies in three different populations: original sample (55% true prevalence of CKD stage 3-5), a screening (6.7% prevalence) and a CKD population (84% prevalence). Results. All three eGFR-equations had high classification ability (area under the receiver-operating-characteristic curve = 97%). The probability of CKD stage 3-5 increased with decreasing eGFR, varied substantially among the populations studied and to some extent between the eGFR-equations. Using the Lund-Malmö equation as illustration, the probability of CKD stage 3-5 is > 90% only when eGFR is <38 mL/min/1.73 m(2) in a screening population, whereas it is > 90% already when eGFR is <51 mL/min/1.73 m(2) in a CKD population. Conversely, the probability of CKD stage 3-5 is <10% if eGFR > 59 mL/min/1.73 m(2) in a screening population, whereas it is <10% only when eGFR is > 88 mL/min/1.73 m(2) in a CKD population. Conclusion. Instead of reporting diagnostic accuracy as sensitivity, specificity, and predictive values, actual eGFR supplemented with the probability that it represents a true GFR <60 mL/min/1.73 m(2) may be more valuable for physicians. Clinical (pre-test) probability in the population must be considered when predicting this probability. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Clinical and Laboratory Investigation
volume
Jul 1
pages
327 - 333
publisher
Informa Healthcare
external identifiers
  • WOS:000282186000004
  • PMID:20545460
  • Scopus:77956019614
ISSN
1502-7686
DOI
10.3109/00365513.2010.488699
language
English
LU publication?
yes
id
5da85be9-b212-4316-8077-bdb1c59ff619 (old id 1626102)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20545460?dopt=Abstract
date added to LUP
2010-07-05 20:25:20
date last changed
2016-10-28 15:21:17
@misc{5da85be9-b212-4316-8077-bdb1c59ff619,
  abstract     = {Abstract Objective. To demonstrate how patients' probability of having chronic kidney disease (CKD) stage 3-5 (measured GFR &lt;60 mL/min/1.73 m(2)) can be predicted from a specific value of estimated glomerular filtration rate (eGFR). Material and methods. The probability of CKD stage 3-5 was predicted from a logistic regression model (n = 850) using three different eGFR prediction equations: Lund-Malmö, MDRD and CKD-EPI. Population weighting was used to illustrate how this probability varies in three different populations: original sample (55% true prevalence of CKD stage 3-5), a screening (6.7% prevalence) and a CKD population (84% prevalence). Results. All three eGFR-equations had high classification ability (area under the receiver-operating-characteristic curve = 97%). The probability of CKD stage 3-5 increased with decreasing eGFR, varied substantially among the populations studied and to some extent between the eGFR-equations. Using the Lund-Malmö equation as illustration, the probability of CKD stage 3-5 is &gt; 90% only when eGFR is &lt;38 mL/min/1.73 m(2) in a screening population, whereas it is &gt; 90% already when eGFR is &lt;51 mL/min/1.73 m(2) in a CKD population. Conversely, the probability of CKD stage 3-5 is &lt;10% if eGFR &gt; 59 mL/min/1.73 m(2) in a screening population, whereas it is &lt;10% only when eGFR is &gt; 88 mL/min/1.73 m(2) in a CKD population. Conclusion. Instead of reporting diagnostic accuracy as sensitivity, specificity, and predictive values, actual eGFR supplemented with the probability that it represents a true GFR &lt;60 mL/min/1.73 m(2) may be more valuable for physicians. Clinical (pre-test) probability in the population must be considered when predicting this probability.},
  author       = {Björk, Jonas and Grubb, Anders and Sterner, Gunnar and Nyman, Ulf},
  issn         = {1502-7686},
  language     = {eng},
  pages        = {327--333},
  publisher    = {ARRAY(0xc698690)},
  series       = {Scandinavian Journal of Clinical and Laboratory Investigation},
  title        = {A new tool for predicting the probability of chronic kidney disease from a specific value of estimated GFR.},
  url          = {http://dx.doi.org/10.3109/00365513.2010.488699},
  volume       = {Jul 1},
  year         = {2010},
}