scholarly journals Estimating glomerular filtration rate: a systematic comparison of the new European Kidney Function Consortium equation to Chronic Kidney Disease Epidemiology Collaboration equation

2020 ◽  
Author(s):  
Florian Buchkremer ◽  
Stephan Segerer
2020 ◽  
Vol 13 (4) ◽  
pp. 674-683 ◽  
Author(s):  
Jonas Björk ◽  
Ulf Nyman ◽  
Marie Courbebaisse ◽  
Lionel Couzi ◽  
R Neil Dalton ◽  
...  

Abstract Background The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved. Methods In a cross-sectional analysis covering the years 2003–17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund–Malmö revised equation (LMR) and the Full Age Spectrum equation. Results 7In patients aged 18–39 years old, CKD-EPI overestimated GFR with 5.0–16 mL/min/1.73 m2 in median in both cohort types at mGFR levels <120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%. Conclusions None of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.


Author(s):  
Francisco Veríssimo Veronese ◽  
Eduardo C. Gomes ◽  
Joana Chanan ◽  
Maicon A. Carraro ◽  
Eduardo G. Camargo ◽  
...  

AbstractThe Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals.This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by theIn the group as a whole,CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m


Author(s):  
V.G. Maidannyk ◽  
E.A. Burlaka ◽  
I.V. Bagdasarova ◽  
S.P. Fomina ◽  
V.M. Nepomnyaschiy

Aim of the study: to study the indicators of cellular hypoxia and apoptosis in pediatric patients with nephritic type of chronic glomerulonephritis. Material and methods: 52patients with active stage of nephrotic type ofChronic glomerulonephritis were inspected. All patients were divided into groups of Chronic Kidney Disease (CKD) by the level of glomerular filtration rate (GFR). Detection of the hypoxia–induced factor (HIF) and antiapoptotic factor Bcl–xL in serum performed using Western Blotting assay and immunohistochemically on material of kidney biopsies. Imaging was done using confocal laser microscopy. Results: it has been found that the disease course is accompanied by increased levels of hypoxia–induced factor HIF–1a and decreased expression of antiapoptotic factor Bcl–xL (in plasma and on biopsies). Detected changes significantly depended on the degree of proteinuria and declining of glomerular filtration rate. Dependence between the levels of hypoxia–induced damages and level of kidney function impairment was documented. In children with Chronic Kidney Disease (SKDIst.) HIF–1a was at level 128.6±2.3% (P<0.01, compared to Control group), in children with CKD II–III st. – 141.3±1.9% (P<0.01, compared to Control group and CKD I st.). Level of antiapoptotic defense in children with nephrotic type of Chronic glomerulonephritis was related to the level of kidney function impairment as well. In group of patient with CKDIst. Bcl–xL expression was down–regulated to 75.1±2.2%, in group with CKDII–IIIst. — to 60.1+1.8% (P<0.01 and P<0.001, compared to Control group, respectively). The level of evaluated changes has a dependence on levels ofproteinuria and kidney function impairment. Conclusion. Studied parameters might be used as predictors of unfavorable disease course.


Author(s):  
Samel Park ◽  
Nam‐Jun Cho ◽  
Nam Hun Heo ◽  
Eun‐Jung Rhee ◽  
Hyowook Gil ◽  
...  

Background The relationship between vascular calcification and chronic kidney disease is well known. However, whether vascular calcification affects renal function deterioration remains unclear. We investigated whether kidney function deteriorated more rapidly in individuals with higher vascular calcification indicated by the coronary artery calcium score (CACS). Methods and Results Individuals with a normal estimated glomerular filtration rate (>60 mL/min per 1.73 m 2 ) who underwent cardiac computed tomography in our institution (a tertiary teaching hospital in Cheonan, Korea) from January 2010 to July 2012 were retrospectively reviewed. All participants were aged 20 to 65 years. Among 739 patients, 447, 175, and 117 had CACSs of 0, 1 to 99, and ≥100 units, respectively. The participants were followed for 7.8 (interquartile range, 5.5–8.8) years. The adjusted annual estimated glomerular filtration rates declined more rapidly in patients in the CACS ≥100 group compared with those in the CACS 0 group (adjusted‐β, −0.40; 95% CI, −0.80 to −0.03) when estimated using a linear mixed model. The adjusted hazard ratio in the CACS ≥100 group for Kidney Disease: Improving Global Outcomes criteria (a drop in estimated glomerular filtration rate category accompanied by a 25% or greater drop in estimated glomerular filtration rate) was 2.52 (1.13–5.61). After propensity score matching, more prevalent renal outcomes (13.2%) were observed in patients with a CACS of ≥100 compared with those with a CACS of 0 (1.9%), with statistical significance ( P =0.004). Conclusions Our results showed that renal function declined more rapidly in patients with higher CACSs, suggesting that vascular calcification might be associated with chronic kidney disease progression.


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