TY - JOUR
T1 - Estimating glomerular filtration rate
T2 - Performance of the CKD-EPI equation over time in patients with type 2 diabetes
AU - Churilov, Leonid
AU - Perera, Nayomi
AU - Thomas, David
AU - Poon, Aurora
AU - Macisaac, Richard J.
AU - Jerums, George
AU - Ekinci, Elif I.
AU - Wood, Anna
PY - 2016/1/1
Y1 - 2016/1/1
N2 - 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.
AB - 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.
KW - hemoglobin A1c
KW - low density lipoprotein cholesterol
KW - pentetic acid
KW - triacylglycerol
KW - adult
KW - aged
KW - Article
KW - diastolic blood pressure
KW - female
KW - glomerulus filtration rate
KW - human
KW - major clinical study
KW - male
KW - measurement
KW - non insulin dependent diabetes mellitus
KW - priority journal
KW - retrospective study
UR - http://www.scopus.com/inward/record.url?scp=84952637755&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2015.08.025
DO - 10.1016/j.jdiacomp.2015.08.025
M3 - Article
C2 - 26597601
SN - 1056-8727
VL - 30
SP - 49
EP - 54
JO - Journal of Diabetes and Its Complications
JF - Journal of Diabetes and Its Complications
IS - 1
ER -