Clinical risk implications of the CKD Epidemiology Collaboration (CKD-EPI) equation compared with the Modification of Diet in Renal Disease (MDRD) Study equation for estimated GFR

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Kunihiro MatsushitaAlberta Kidney Disease Network

Abstract

The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine-based equation for estimated glomerular filtration rate (eGFR) is more accurate than the MDRD (Modification of Diet in Renal Disease) Study equation. However, it has not been determined whether the improvement in risk categorization applies to all segments of the population. Population-based cohort study. Adults (aged ≥18 years) who did not have kidney failure at baseline and had at least one serum creatinine measurement and dipstick proteinuria evaluation in a province-wide laboratory registry from Alberta, Canada, in 2002-2007 (N = 1,010,988). eGFR categories of ≥90, 60-89, 45-59, 30-44, and 15-29 mL/min/1.73 m(2). All-cause mortality, acute myocardial infarction, end-stage renal disease, and doubling of serum creatinine level. GFR was estimated by the CKD-EPI and MDRD Study equations. The CKD-EPI equation reclassified 22.6% and 1.2% of participants to a higher and lower eGFR category, respectively, and decreased the prevalence of CKD stages 3 and 4 from 9.2% to 7.3%. Of 70,071 participants with eGFR(MDRD) of 45-59 mL/min/1.73 m(2), 30.8% were reclassified to eGFR(CKD-EPI) of 60-89 mL/min/1.73 m(2), and after adjusting for potential confounders, partic...Continue Reading

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