Estimating glomerular filtration rate: Performance of the CKD-EPI equation over time in patients with type 2 diabetes

Anna J. Wood, Leonid Churilov, Nayomi Perera, David Thomas, Aurora Poon, Richard J. Macisaac, George Jerums, Elif I. Ekinci

    Research output: Contribution to journalArticle

    Abstract

    Aims: To assess the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation at baseline and longitudinally in people with type 2 diabetes.

    Methods: Adults with type 2 diabetes attending Austin Health, Melbourne, with ≤ 3 prospective GFR measurements were included in this retrospective study. Plasma disappearance rate of DTPA (diethylene-triamine-penta-acetic acid) was used to calculate measured GFR (mGFR) and compared to estimated GFR (EGFR). The agreement between mGFR and EGFR was estimated using Intraclass Correlation Coefficient (ICC). 

    Results: 152 patients had a median of 4 (IQR: 3, 5) mGFR measurements over a period of 11 years (IQR: 9, 12). The difference between mGFR and EGFR increased proportionally to the magnitude of the GFR, increasing by 0.2 ml/min/1.73 m2 for every 1 ml/min/1.73 m2 increase in mGFR, indicative of proportional bias. At lower mGFR levels, EGFR overestimated mGFR, and at higher mGFR levels, EGFR underestimated mGFR. There was a significant association between LDL cholesterol, triglycerides, HbA1c, diastolic blood pressure and the difference between mGFR and EGFR.

    Conclusions: The CKD-EPI formula underestimates mGFR and the rate of decline of mGFR in patients with type 2 diabetes with an mGFR greater than 60 ml/min/1.73 m2. The association between LDL cholesterol, triglycerides, HbA1c, diastolic blood pressure and the difference between mGFR and EGFR warrants further study.

    Original languageEnglish
    Pages (from-to)49-54
    Number of pages6
    JournalJournal of Diabetes and Its Complications
    Volume30
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2016

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