Validation of the Lund-Malmö, Chronic Kidney Disease Epidemiology (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations to estimate glomerular filtration rate in a large Swedish clinical population.
(2012) In Scandinavian Journal of Urology and Nephrology 46(3). p.212-222- Abstract
- Abstract Objective. The aim of this study was to validate externally the Swedish Lund-Malmö revised creatinine-based glomerular filtration rate (GFR) equations (LM Revised) in a Swedish cohort in comparison with the North American Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology (CKD-EPI) equations. Material and methods. The study included 1397 examinations [median age 61 years, median body mass index (BMI) 26 kg/m(2)] in 996 patients referred for iohexol clearance (median 44 ml/min/1.73 m(2)). Bias, precision [interquartile range (IQR)], 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,... (More)
- Abstract Objective. The aim of this study was to validate externally the Swedish Lund-Malmö revised creatinine-based glomerular filtration rate (GFR) equations (LM Revised) in a Swedish cohort in comparison with the North American Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology (CKD-EPI) equations. Material and methods. The study included 1397 examinations [median age 61 years, median body mass index (BMI) 26 kg/m(2)] in 996 patients referred for iohexol clearance (median 44 ml/min/1.73 m(2)). Bias, precision [interquartile range (IQR)], 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, all three equations performed satisfactorily: LM Revised, MDRD, CKD-EPI showed, respectively, a median bias of -5.8%, -2.2% and 1.7%, IQR 11.9, 12.3 and 11.7 ml/min/1.73 m(2), P (10) 35%, 34% and 38%, P (30) 84%, 79% and 79% and correctly classified GFR stages 68%, 65% and 69%. LM Revised was at least as accurate in terms of P (30) as the other equations at GFR intervals <90, while CKD-EPI was the only unbiased and the most accurate equation at ≥90 ml/min/1.73 m(2). LM Revised was more stable in terms of bias and accuracy across age and BMI groups than MDRD and CKD-EPI. Both MDRD and CKD-EPI overestimated measured GFR among elderly patients and in the small group of underweight men. Conclusion. The ideal all-purpose GFR prediction equation does not exist. LM Revised should be preferred in patients with suspected or known renal insufficiency, while CKD-EPI is most useful in settings where patients with no a priori suspicion of renal impairment are evaluated. Differences in creatinine measurements between laboratories may limit the generalizability of the present validation. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2336322
- author
- Björk, Jonas LU ; Jones, Ian ; Nyman, Ulf LU and Sjöström, Per
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Urology and Nephrology
- volume
- 46
- issue
- 3
- pages
- 212 - 222
- publisher
- Taylor & Francis
- external identifiers
-
- wos:000304102900008
- pmid:22250974
- scopus:84861088109
- pmid:22250974
- ISSN
- 1651-2065
- DOI
- 10.3109/00365599.2011.644859
- language
- English
- LU publication?
- yes
- id
- 6dc1523f-221d-400f-ba56-aa0a8c653e66 (old id 2336322)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/22250974?dopt=Abstract
- date added to LUP
- 2016-04-04 09:35:03
- date last changed
- 2022-01-29 18:32:37
@article{6dc1523f-221d-400f-ba56-aa0a8c653e66, abstract = {{Abstract Objective. The aim of this study was to validate externally the Swedish Lund-Malmö revised creatinine-based glomerular filtration rate (GFR) equations (LM Revised) in a Swedish cohort in comparison with the North American Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology (CKD-EPI) equations. Material and methods. The study included 1397 examinations [median age 61 years, median body mass index (BMI) 26 kg/m(2)] in 996 patients referred for iohexol clearance (median 44 ml/min/1.73 m(2)). Bias, precision [interquartile range (IQR)], 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, all three equations performed satisfactorily: LM Revised, MDRD, CKD-EPI showed, respectively, a median bias of -5.8%, -2.2% and 1.7%, IQR 11.9, 12.3 and 11.7 ml/min/1.73 m(2), P (10) 35%, 34% and 38%, P (30) 84%, 79% and 79% and correctly classified GFR stages 68%, 65% and 69%. LM Revised was at least as accurate in terms of P (30) as the other equations at GFR intervals <90, while CKD-EPI was the only unbiased and the most accurate equation at ≥90 ml/min/1.73 m(2). LM Revised was more stable in terms of bias and accuracy across age and BMI groups than MDRD and CKD-EPI. Both MDRD and CKD-EPI overestimated measured GFR among elderly patients and in the small group of underweight men. Conclusion. The ideal all-purpose GFR prediction equation does not exist. LM Revised should be preferred in patients with suspected or known renal insufficiency, while CKD-EPI is most useful in settings where patients with no a priori suspicion of renal impairment are evaluated. Differences in creatinine measurements between laboratories may limit the generalizability of the present validation.}}, author = {{Björk, Jonas and Jones, Ian and Nyman, Ulf and Sjöström, Per}}, issn = {{1651-2065}}, language = {{eng}}, number = {{3}}, pages = {{212--222}}, publisher = {{Taylor & Francis}}, series = {{Scandinavian Journal of Urology and Nephrology}}, title = {{Validation of the Lund-Malmö, Chronic Kidney Disease Epidemiology (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations to estimate glomerular filtration rate in a large Swedish clinical population.}}, url = {{http://dx.doi.org/10.3109/00365599.2011.644859}}, doi = {{10.3109/00365599.2011.644859}}, volume = {{46}}, year = {{2012}}, }