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Development and validation of GFR-estimating equations using diabetes, transplant and weight

Stevens, Lesley A.; Schmid, Christopher H.; Zhang, Yaping L.; Coresh, Josef; Manzi, Jane; Landis, Richard; Bakoush, Omran LU ; Contreras, Gabriel; Genuth, Saul and Klintmalm, Goran B., et al. (2010) In Nephrology Dialysis Transplantation 25(2). p.449-457
Abstract
Methods. Linear regression was used to relate log-measured GFR (mGFR) to sex, race, diabetes, transplant, weight, various transformations of creatinine and age with and without interactions. Equations were developed in a pooled database of 10 studies [2/3 (N = 5504) for development and 1/3 (N = 2750) for internal validation], and final model selection occurred in 16 additional studies [external validation (N = 3896)]. Results. The mean mGFR was 68, 67 and 68 ml/min/ 1.73 m(2) in the development, internal validation and external validation datasets, respectively. In external validation, an equation that included a linear age term and spline terms in creatinine to account for a reduction in the magnitude of the slope at low serum creatinine... (More)
Methods. Linear regression was used to relate log-measured GFR (mGFR) to sex, race, diabetes, transplant, weight, various transformations of creatinine and age with and without interactions. Equations were developed in a pooled database of 10 studies [2/3 (N = 5504) for development and 1/3 (N = 2750) for internal validation], and final model selection occurred in 16 additional studies [external validation (N = 3896)]. Results. The mean mGFR was 68, 67 and 68 ml/min/ 1.73 m(2) in the development, internal validation and external validation datasets, respectively. In external validation, an equation that included a linear age term and spline terms in creatinine to account for a reduction in the magnitude of the slope at low serum creatinine values exhibited the best performance (bias = 2.5, RMSE = 0.250) among models using the four basic predictor variables. Addition of terms for diabetes and transplant did not improve performance. Equations with weight showed a small improvement in the subgroup with BMI < 20 kg/m(2). Conclusions. The CKD-EPI equation, based on creatinine, age, sex and race, has been validated and is more accurate than the MDRD study equation. The addition of weight, diabetes and transplant does not significantly improve equation performance. (Less)
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Contribution to journal
publication status
published
subject
keywords
rate, validation, glomerular filtration, estimating equation, creatinine, development
in
Nephrology Dialysis Transplantation
volume
25
issue
2
pages
449 - 457
publisher
Oxford University Press
external identifiers
  • wos:000273891600022
  • scopus:75649116099
ISSN
1460-2385
DOI
10.1093/ndt/gfp510
language
English
LU publication?
yes
id
e3d5bf81-9691-47c0-8d2f-aed23e5a603f (old id 1547207)
date added to LUP
2010-02-24 10:37:48
date last changed
2018-05-29 11:47:44
@article{e3d5bf81-9691-47c0-8d2f-aed23e5a603f,
  abstract     = {Methods. Linear regression was used to relate log-measured GFR (mGFR) to sex, race, diabetes, transplant, weight, various transformations of creatinine and age with and without interactions. Equations were developed in a pooled database of 10 studies [2/3 (N = 5504) for development and 1/3 (N = 2750) for internal validation], and final model selection occurred in 16 additional studies [external validation (N = 3896)]. Results. The mean mGFR was 68, 67 and 68 ml/min/ 1.73 m(2) in the development, internal validation and external validation datasets, respectively. In external validation, an equation that included a linear age term and spline terms in creatinine to account for a reduction in the magnitude of the slope at low serum creatinine values exhibited the best performance (bias = 2.5, RMSE = 0.250) among models using the four basic predictor variables. Addition of terms for diabetes and transplant did not improve performance. Equations with weight showed a small improvement in the subgroup with BMI &lt; 20 kg/m(2). Conclusions. The CKD-EPI equation, based on creatinine, age, sex and race, has been validated and is more accurate than the MDRD study equation. The addition of weight, diabetes and transplant does not significantly improve equation performance.},
  author       = {Stevens, Lesley A. and Schmid, Christopher H. and Zhang, Yaping L. and Coresh, Josef and Manzi, Jane and Landis, Richard and Bakoush, Omran and Contreras, Gabriel and Genuth, Saul and Klintmalm, Goran B. and Poggio, Emilio and Rossing, Peter and Rule, Andrew D. and Weir, Matthew R. and Kusek, John and Greene, Tom and Levey, Andrew S.},
  issn         = {1460-2385},
  keyword      = {rate,validation,glomerular filtration,estimating equation,creatinine,development},
  language     = {eng},
  number       = {2},
  pages        = {449--457},
  publisher    = {Oxford University Press},
  series       = {Nephrology Dialysis Transplantation},
  title        = {Development and validation of GFR-estimating equations using diabetes, transplant and weight},
  url          = {http://dx.doi.org/10.1093/ndt/gfp510},
  volume       = {25},
  year         = {2010},
}