Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes

The eGFR Study

Louise Maple-Brown, Elif Ekinci, Jaquelyne Hughes, Mark Chatfield, Paul Lawton, Graham Jones, Andrew G Ellis, A Sinha, Alan Cass, Wendy Hoy, Kerin O'Dea, George Jerums, R MacIsaac

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Aims: It has been proposed that the Chronic Kidney Disease Epidemiology Collaboration formula estimates glomerular filtration rate more accurately than the Modification of Diet in Renal Disease formula. With the very high incidence of diabetes and end-stage kidney disease in Indigenous Australians, accurate estimation of glomerular filtration rate is vital in early detection of kidney disease. We aimed to assess the performance of the Chronic Kidney Disease Epidemiology Collaboration, Modification of Diet in Renal Disease and Cockcroft–Gault formulas in Indigenous Australians with and without diabetes.

    Methods: 
    Indigenous Australians with (n = 224) or without (n = 340) Type 2 diabetes had a reference glomerular filtration rate measure using plasma disappearance of iohexol (measured glomerular filtration rate) over 4 h. Serum creatinine was measured by an enzymatic method. Performance was assessed by bias (measured glomerular filtration rate – estimated glomerular filtration rate) and accuracy (percentage of estimated glomerular filtration rate within 30% of measured glomerular filtration rate).

    Results: 
    The median measured glomerular filtration rate (interquartile range) in participants with or without diabetes was 97 (68–119) and 108 (90–122) ml min−1 1.73 m−2, respectively. The Chronic Kidney Disease Epidemiology Collaboration formula had smaller bias and greater accuracy than the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall, for participants both with and without diabetes. However, for estimated glomerular filtration rate > 90 ml min−1 1.73 m−2, the Chronic Kidney Disease Epidemiology Collaboration formula had greater bias in participants with diabetes, underestimating measured glomerular filtration rate by 7.4 vs. 1.0 ml min−1 1.73 m−2 in those without diabetes. The Chronic Kidney Disease Epidemiology Collaboration formula was less accurate across the whole range of estimated glomerular filtration rates in participants with vs. those without diabetes (87.1% vs. 93.3%).

    Conclusions: 
    The Chronic Kidney Disease Epidemiology Collaboration formula outperforms the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall in Indigenous Australians with and without diabetes. However, the Chronic Kidney Disease Epidemiology Collaboration formula has greater bias in people with diabetes compared with those without diabetes, especially in those with normal renal function.
    Original languageEnglish
    Pages (from-to)829-838
    Number of pages10
    JournalDiabetic Medicine
    Volume31
    Issue number7
    DOIs
    Publication statusPublished - Jul 2014

    Fingerprint

    Glomerular Filtration Rate
    Type 2 Diabetes Mellitus
    Chronic Renal Insufficiency
    Epidemiology
    Diet Therapy
    Kidney
    Iohexol
    Kidney Diseases
    Chronic Kidney Failure
    Early Diagnosis
    Creatinine

    Cite this

    Maple-Brown, Louise ; Ekinci, Elif ; Hughes, Jaquelyne ; Chatfield, Mark ; Lawton, Paul ; Jones, Graham ; Ellis, Andrew G ; Sinha, A ; Cass, Alan ; Hoy, Wendy ; O'Dea, Kerin ; Jerums, George ; MacIsaac, R. / Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes : The eGFR Study. In: Diabetic Medicine. 2014 ; Vol. 31, No. 7. pp. 829-838.
    @article{28d3cc33f170481d9d2d331eb59f436c,
    title = "Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes: The eGFR Study",
    abstract = "Aims: It has been proposed that the Chronic Kidney Disease Epidemiology Collaboration formula estimates glomerular filtration rate more accurately than the Modification of Diet in Renal Disease formula. With the very high incidence of diabetes and end-stage kidney disease in Indigenous Australians, accurate estimation of glomerular filtration rate is vital in early detection of kidney disease. We aimed to assess the performance of the Chronic Kidney Disease Epidemiology Collaboration, Modification of Diet in Renal Disease and Cockcroft–Gault formulas in Indigenous Australians with and without diabetes.Methods: Indigenous Australians with (n = 224) or without (n = 340) Type 2 diabetes had a reference glomerular filtration rate measure using plasma disappearance of iohexol (measured glomerular filtration rate) over 4 h. Serum creatinine was measured by an enzymatic method. Performance was assessed by bias (measured glomerular filtration rate – estimated glomerular filtration rate) and accuracy (percentage of estimated glomerular filtration rate within 30{\%} of measured glomerular filtration rate).Results: The median measured glomerular filtration rate (interquartile range) in participants with or without diabetes was 97 (68–119) and 108 (90–122) ml min−1 1.73 m−2, respectively. The Chronic Kidney Disease Epidemiology Collaboration formula had smaller bias and greater accuracy than the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall, for participants both with and without diabetes. However, for estimated glomerular filtration rate > 90 ml min−1 1.73 m−2, the Chronic Kidney Disease Epidemiology Collaboration formula had greater bias in participants with diabetes, underestimating measured glomerular filtration rate by 7.4 vs. 1.0 ml min−1 1.73 m−2 in those without diabetes. The Chronic Kidney Disease Epidemiology Collaboration formula was less accurate across the whole range of estimated glomerular filtration rates in participants with vs. those without diabetes (87.1{\%} vs. 93.3{\%}).Conclusions: The Chronic Kidney Disease Epidemiology Collaboration formula outperforms the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall in Indigenous Australians with and without diabetes. However, the Chronic Kidney Disease Epidemiology Collaboration formula has greater bias in people with diabetes compared with those without diabetes, especially in those with normal renal function.",
    keywords = "creatinine, iohexol, adult, Article, blood sampling, calculation, chronic kidney disease, Cockcroft Gault formula, controlled study, creatinine blood level, creatinine clearance, diabetic patient, female, glomerulus filtration rate, human, Indigenous Australian, kidney function, major clinical study, male, measurement accuracy, non insulin dependent diabetes mellitus, Australia, comparative study, Diabetes Mellitus, Type 2, diabetic diet, diagnostic use, early diagnosis, indigenous health care, kidney function test, metabolism, middle aged, Oceanic ancestry group, pathophysiology, predictive value, procedures, Renal Insufficiency, Chronic, reproducibility, Creatinine, Diabetic Diet, Early Diagnosis, Female, Glomerular Filtration Rate, Health Services, Indigenous, Humans, Iohexol, Kidney Function Tests, Male, Middle Aged, Oceanic Ancestry Group, Predictive Value of Tests, Reproducibility of Results",
    author = "Louise Maple-Brown and Elif Ekinci and Jaquelyne Hughes and Mark Chatfield and Paul Lawton and Graham Jones and Ellis, {Andrew G} and A Sinha and Alan Cass and Wendy Hoy and Kerin O'Dea and George Jerums and R MacIsaac",
    year = "2014",
    month = "7",
    doi = "10.1111/dme.12426",
    language = "English",
    volume = "31",
    pages = "829--838",
    journal = "Diabetic Medicine",
    issn = "0742-3071",
    publisher = "Wiley-Blackwell",
    number = "7",

    }

    Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes : The eGFR Study. / Maple-Brown, Louise; Ekinci, Elif; Hughes, Jaquelyne; Chatfield, Mark; Lawton, Paul; Jones, Graham; Ellis, Andrew G; Sinha, A; Cass, Alan; Hoy, Wendy; O'Dea, Kerin; Jerums, George; MacIsaac, R.

    In: Diabetic Medicine, Vol. 31, No. 7, 07.2014, p. 829-838.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes

    T2 - The eGFR Study

    AU - Maple-Brown, Louise

    AU - Ekinci, Elif

    AU - Hughes, Jaquelyne

    AU - Chatfield, Mark

    AU - Lawton, Paul

    AU - Jones, Graham

    AU - Ellis, Andrew G

    AU - Sinha, A

    AU - Cass, Alan

    AU - Hoy, Wendy

    AU - O'Dea, Kerin

    AU - Jerums, George

    AU - MacIsaac, R

    PY - 2014/7

    Y1 - 2014/7

    N2 - Aims: It has been proposed that the Chronic Kidney Disease Epidemiology Collaboration formula estimates glomerular filtration rate more accurately than the Modification of Diet in Renal Disease formula. With the very high incidence of diabetes and end-stage kidney disease in Indigenous Australians, accurate estimation of glomerular filtration rate is vital in early detection of kidney disease. We aimed to assess the performance of the Chronic Kidney Disease Epidemiology Collaboration, Modification of Diet in Renal Disease and Cockcroft–Gault formulas in Indigenous Australians with and without diabetes.Methods: Indigenous Australians with (n = 224) or without (n = 340) Type 2 diabetes had a reference glomerular filtration rate measure using plasma disappearance of iohexol (measured glomerular filtration rate) over 4 h. Serum creatinine was measured by an enzymatic method. Performance was assessed by bias (measured glomerular filtration rate – estimated glomerular filtration rate) and accuracy (percentage of estimated glomerular filtration rate within 30% of measured glomerular filtration rate).Results: The median measured glomerular filtration rate (interquartile range) in participants with or without diabetes was 97 (68–119) and 108 (90–122) ml min−1 1.73 m−2, respectively. The Chronic Kidney Disease Epidemiology Collaboration formula had smaller bias and greater accuracy than the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall, for participants both with and without diabetes. However, for estimated glomerular filtration rate > 90 ml min−1 1.73 m−2, the Chronic Kidney Disease Epidemiology Collaboration formula had greater bias in participants with diabetes, underestimating measured glomerular filtration rate by 7.4 vs. 1.0 ml min−1 1.73 m−2 in those without diabetes. The Chronic Kidney Disease Epidemiology Collaboration formula was less accurate across the whole range of estimated glomerular filtration rates in participants with vs. those without diabetes (87.1% vs. 93.3%).Conclusions: The Chronic Kidney Disease Epidemiology Collaboration formula outperforms the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall in Indigenous Australians with and without diabetes. However, the Chronic Kidney Disease Epidemiology Collaboration formula has greater bias in people with diabetes compared with those without diabetes, especially in those with normal renal function.

    AB - Aims: It has been proposed that the Chronic Kidney Disease Epidemiology Collaboration formula estimates glomerular filtration rate more accurately than the Modification of Diet in Renal Disease formula. With the very high incidence of diabetes and end-stage kidney disease in Indigenous Australians, accurate estimation of glomerular filtration rate is vital in early detection of kidney disease. We aimed to assess the performance of the Chronic Kidney Disease Epidemiology Collaboration, Modification of Diet in Renal Disease and Cockcroft–Gault formulas in Indigenous Australians with and without diabetes.Methods: Indigenous Australians with (n = 224) or without (n = 340) Type 2 diabetes had a reference glomerular filtration rate measure using plasma disappearance of iohexol (measured glomerular filtration rate) over 4 h. Serum creatinine was measured by an enzymatic method. Performance was assessed by bias (measured glomerular filtration rate – estimated glomerular filtration rate) and accuracy (percentage of estimated glomerular filtration rate within 30% of measured glomerular filtration rate).Results: The median measured glomerular filtration rate (interquartile range) in participants with or without diabetes was 97 (68–119) and 108 (90–122) ml min−1 1.73 m−2, respectively. The Chronic Kidney Disease Epidemiology Collaboration formula had smaller bias and greater accuracy than the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall, for participants both with and without diabetes. However, for estimated glomerular filtration rate > 90 ml min−1 1.73 m−2, the Chronic Kidney Disease Epidemiology Collaboration formula had greater bias in participants with diabetes, underestimating measured glomerular filtration rate by 7.4 vs. 1.0 ml min−1 1.73 m−2 in those without diabetes. The Chronic Kidney Disease Epidemiology Collaboration formula was less accurate across the whole range of estimated glomerular filtration rates in participants with vs. those without diabetes (87.1% vs. 93.3%).Conclusions: The Chronic Kidney Disease Epidemiology Collaboration formula outperforms the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall in Indigenous Australians with and without diabetes. However, the Chronic Kidney Disease Epidemiology Collaboration formula has greater bias in people with diabetes compared with those without diabetes, especially in those with normal renal function.

    KW - creatinine

    KW - iohexol

    KW - adult

    KW - Article

    KW - blood sampling

    KW - calculation

    KW - chronic kidney disease

    KW - Cockcroft Gault formula

    KW - controlled study

    KW - creatinine blood level

    KW - creatinine clearance

    KW - diabetic patient

    KW - female

    KW - glomerulus filtration rate

    KW - human

    KW - Indigenous Australian

    KW - kidney function

    KW - major clinical study

    KW - male

    KW - measurement accuracy

    KW - non insulin dependent diabetes mellitus

    KW - Australia

    KW - comparative study

    KW - Diabetes Mellitus, Type 2

    KW - diabetic diet

    KW - diagnostic use

    KW - early diagnosis

    KW - indigenous health care

    KW - kidney function test

    KW - metabolism

    KW - middle aged

    KW - Oceanic ancestry group

    KW - pathophysiology

    KW - predictive value

    KW - procedures

    KW - Renal Insufficiency, Chronic

    KW - reproducibility

    KW - Creatinine

    KW - Diabetic Diet

    KW - Early Diagnosis

    KW - Female

    KW - Glomerular Filtration Rate

    KW - Health Services, Indigenous

    KW - Humans

    KW - Iohexol

    KW - Kidney Function Tests

    KW - Male

    KW - Middle Aged

    KW - Oceanic Ancestry Group

    KW - Predictive Value of Tests

    KW - Reproducibility of Results

    U2 - 10.1111/dme.12426

    DO - 10.1111/dme.12426

    M3 - Article

    VL - 31

    SP - 829

    EP - 838

    JO - Diabetic Medicine

    JF - Diabetic Medicine

    SN - 0742-3071

    IS - 7

    ER -