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The CKD-EPI and MDRD equations to estimate GFR. Validation in the Swedish Lund-Malmo Study cohort

Nyman, Ulf; Grubb, Anders LU ; Sterner, Gunnar LU and Björk, Jonas LU (2011) In Scandinavian Journal of Clinical & Laboratory Investigation 71(2). p.129-138
Abstract
Objective. To compare the recently developed CKD-EPI equation to estimate GFR in adult Swedish-Caucasians with the MDRD equation. Material and methods. Swedish-Caucasians (N = 850, 376 females; median age 60, range 5-95 years) referred for plasma iohexol-clearance (median 55, range 5-223 mL/min/1.73 m(2)) constituted the Lund-Malmo Study cohort. Bias, precision (interquartile range, IQR, of the differences between estimated and measured GFR), accuracy expressed as percentage of estimates +/- 10% (P-10) and +/- 30% (P-30) of measured GFR, and classification ability for five GFR stages < 15, 15-29, 30-59, 60-89 and >= 90 mL/min/1.73 m(2) were compared. Results. Overall there were no important differences between the equations;... (More)
Objective. To compare the recently developed CKD-EPI equation to estimate GFR in adult Swedish-Caucasians with the MDRD equation. Material and methods. Swedish-Caucasians (N = 850, 376 females; median age 60, range 5-95 years) referred for plasma iohexol-clearance (median 55, range 5-223 mL/min/1.73 m(2)) constituted the Lund-Malmo Study cohort. Bias, precision (interquartile range, IQR, of the differences between estimated and measured GFR), accuracy expressed as percentage of estimates +/- 10% (P-10) and +/- 30% (P-30) of measured GFR, and classification ability for five GFR stages < 15, 15-29, 30-59, 60-89 and >= 90 mL/min/1.73 m(2) were compared. Results. Overall there were no important differences between the equations; CKD-EPI/MDRD median values of bias +5.4%/+3.4%, IQR both 14 mL/min/1.73 m(2), P-10 36%/34%, P-30 both 80%, and correctly classified GFR stages 68%/67%. P-30 for the CKD-EPI equation was substantially higher than for MDRD at GFR >= 90 mL/min/1.73 m(2) (93% versus 79%). The MDRD equation performed better in the GFR interval 30-89 mL/min/1.73 m(2), while accuracy was limited for both equations at GFR < 30 mL/min/1.73 m(2) (P-30 < 75% in both females and males). The CKD-EPI/MDRD equations caused a +22%/ +14% bias in the 18-39 year interval and the MDRD equation a + 18% bias >= 80 years. Both equations performed poorly in males with BMI < 20 kg/m(2) (CKD-EPI/MDRD median bias +36%/46%). Conclusion. Overall the recently developed CKD-EPI equation performed well but was not superior to the MDRD equation. The CKD-EPI equation may be preferred in screenings of general populations and in the elderly. None of the equations appeared reliable among patients with markedly decreased GFR, young adults and underweight males. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Kidney disease, kidney function tests, glomerular filtration rate, renal insufficiency
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
71
issue
2
pages
129 - 138
publisher
Informa Healthcare
external identifiers
  • wos:000288126400010
  • scopus:79952424055
ISSN
1502-7686
DOI
10.3109/00365513.2010.543143
language
English
LU publication?
yes
id
a96e50c1-bc41-4054-9f10-31437b90771e (old id 1868216)
date added to LUP
2011-04-04 10:26:01
date last changed
2017-04-09 03:58:20
@article{a96e50c1-bc41-4054-9f10-31437b90771e,
  abstract     = {Objective. To compare the recently developed CKD-EPI equation to estimate GFR in adult Swedish-Caucasians with the MDRD equation. Material and methods. Swedish-Caucasians (N = 850, 376 females; median age 60, range 5-95 years) referred for plasma iohexol-clearance (median 55, range 5-223 mL/min/1.73 m(2)) constituted the Lund-Malmo Study cohort. Bias, precision (interquartile range, IQR, of the differences between estimated and measured GFR), accuracy expressed as percentage of estimates +/- 10% (P-10) and +/- 30% (P-30) of measured GFR, and classification ability for five GFR stages &lt; 15, 15-29, 30-59, 60-89 and &gt;= 90 mL/min/1.73 m(2) were compared. Results. Overall there were no important differences between the equations; CKD-EPI/MDRD median values of bias +5.4%/+3.4%, IQR both 14 mL/min/1.73 m(2), P-10 36%/34%, P-30 both 80%, and correctly classified GFR stages 68%/67%. P-30 for the CKD-EPI equation was substantially higher than for MDRD at GFR &gt;= 90 mL/min/1.73 m(2) (93% versus 79%). The MDRD equation performed better in the GFR interval 30-89 mL/min/1.73 m(2), while accuracy was limited for both equations at GFR &lt; 30 mL/min/1.73 m(2) (P-30 &lt; 75% in both females and males). The CKD-EPI/MDRD equations caused a +22%/ +14% bias in the 18-39 year interval and the MDRD equation a + 18% bias &gt;= 80 years. Both equations performed poorly in males with BMI &lt; 20 kg/m(2) (CKD-EPI/MDRD median bias +36%/46%). Conclusion. Overall the recently developed CKD-EPI equation performed well but was not superior to the MDRD equation. The CKD-EPI equation may be preferred in screenings of general populations and in the elderly. None of the equations appeared reliable among patients with markedly decreased GFR, young adults and underweight males.},
  author       = {Nyman, Ulf and Grubb, Anders and Sterner, Gunnar and Björk, Jonas},
  issn         = {1502-7686},
  keyword      = {Kidney disease,kidney function tests,glomerular filtration rate,renal insufficiency},
  language     = {eng},
  number       = {2},
  pages        = {129--138},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {The CKD-EPI and MDRD equations to estimate GFR. Validation in the Swedish Lund-Malmo Study cohort},
  url          = {http://dx.doi.org/10.3109/00365513.2010.543143},
  volume       = {71},
  year         = {2011},
}