A new tool for predicting the probability of chronic kidney disease from a specific value of estimated GFR.
(2010) In Scandinavian Journal of Clinical and Laboratory Investigation Jul 1. p.327333 Abstract
 Abstract Objective. To demonstrate how patients' probability of having chronic kidney disease (CKD) stage 35 (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 35 was predicted from a logistic regression model (n = 850) using three different eGFR prediction equations: LundMalmö, MDRD and CKDEPI. Population weighting was used to illustrate how this probability varies in three different populations: original sample (55% true prevalence of CKD stage 35), a screening (6.7% prevalence) and a CKD population (84% prevalence). Results. All three eGFRequations had high classification ability (area under the... (More)
 Abstract Objective. To demonstrate how patients' probability of having chronic kidney disease (CKD) stage 35 (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 35 was predicted from a logistic regression model (n = 850) using three different eGFR prediction equations: LundMalmö, MDRD and CKDEPI. Population weighting was used to illustrate how this probability varies in three different populations: original sample (55% true prevalence of CKD stage 35), a screening (6.7% prevalence) and a CKD population (84% prevalence). Results. All three eGFRequations had high classification ability (area under the receiveroperatingcharacteristic curve = 97%). The probability of CKD stage 35 increased with decreasing eGFR, varied substantially among the populations studied and to some extent between the eGFRequations. Using the LundMalmö equation as illustration, the probability of CKD stage 35 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 35 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 (pretest) probability in the population must be considered when predicting this probability. (Less)
Please use this url to cite or link to this publication:
http://lup.lub.lu.se/record/1626102
 author
 Björk, Jonas ^{LU} ; Grubb, Anders ^{LU} ; Sterner, Gunnar ^{LU} and Nyman, Ulf ^{LU}
 organization
 publishing date
 2010
 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
 15027686
 DOI
 10.3109/00365513.2010.488699
 language
 English
 LU publication?
 yes
 id
 5da85be9b21243168077bdb1c59ff619 (old id 1626102)
 alternative location
 http://www.ncbi.nlm.nih.gov/pubmed/20545460?dopt=Abstract
 date added to LUP
 20100705 20:25:20
 date last changed
 20170101 07:47:55
@article{5da85be9b21243168077bdb1c59ff619, abstract = {Abstract Objective. To demonstrate how patients' probability of having chronic kidney disease (CKD) stage 35 (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 35 was predicted from a logistic regression model (n = 850) using three different eGFR prediction equations: LundMalmö, MDRD and CKDEPI. Population weighting was used to illustrate how this probability varies in three different populations: original sample (55% true prevalence of CKD stage 35), a screening (6.7% prevalence) and a CKD population (84% prevalence). Results. All three eGFRequations had high classification ability (area under the receiveroperatingcharacteristic curve = 97%). The probability of CKD stage 35 increased with decreasing eGFR, varied substantially among the populations studied and to some extent between the eGFRequations. Using the LundMalmö equation as illustration, the probability of CKD stage 35 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 35 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 (pretest) probability in the population must be considered when predicting this probability.}, author = {Björk, Jonas and Grubb, Anders and Sterner, Gunnar and Nyman, Ulf}, issn = {15027686}, language = {eng}, pages = {327333}, publisher = {Informa Healthcare}, 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}, }