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Newer Model Better Identifies eGFR-Related Risks

Last Updated: May 08, 2012.

 

More accurate classification of mortality risk, end-stage renal disease with CKD-EPI equation

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The Chronic Kidney Disease Epidemiology Collaboration equation more accurately identifies the risk implications of estimated glomerular filtration rate than the Modification of Diet in Renal Disease Study equation, according to research published in the May 9 issue of the Journal of the American Medical Association.

TUESDAY, May 8 (HealthDay News) -- The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately identifies the risk implications of estimated glomerular filtration rate (eGFR) than the Modification of Diet in Renal Disease (MDRD) Study equation, according to research published in the May 9 issue of the Journal of the American Medical Association.

To compare the risk implications of eGFR using the CKD-EPI equation and the MDRD Study equation, Kunihiro Matsushita, M.D., Ph.D., from Johns Hopkins University in Baltimore, and colleagues conducted a meta-analysis of data from 1.1 million adults (aged ≥18 years) from 25 general population cohorts, seven high-risk cohorts (of vascular disease), and 13 CKD cohorts.

The researchers found that both equations classified the eGFR into six categories (≥90, 60 to 89, 45 to 59, 30 to 44, 15 to 29, and <15 mL/min/1.73 m²). Using the CKD-EPI equation, 24.4 and 0.6 percent of participants from the general population cohort were reclassified to a higher and lower eGFR category, respectively, compared with the MDRD Study equation, and there was a reduction from 8.7 to 6.3 percent in the prevalence of CKD stages 3 to 5 (eGFR <60 mL/min/1.73 m²). Using the MDRD study equation for eGFR of 45 to 59 mL/min/1.73 m², 34.7 percent of participants were reclassified to 60 to 89 mL/min/1.73 m² by the CKD-EPI equation and had reduced incidence rates for all-cause mortality (adjusted hazard ratio [aHR], 0.80), cardiovascular mortality (aHR, 0.73), and end-stage renal disease (aHR, 0.49), compared with those who were not reclassified.

"The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and end-stage renal disease than did the MDRD Study equation across a broad range of populations," the authors write.

Two authors disclosed financial ties to the biotechnology and pharmaceutical industries.

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Copyright © 2012 HealthDay. All rights reserved.


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