Clinical utility of creatinine- and cystatin C-based definition of renal function for risk prediction of primary cardiovascular events in patients with diabetes.

Diabetes Care
Ben SchöttkerDietrich Rothenbacher

Abstract

To assess the cardiovascular risk of diabetic subjects with chronic kidney disease (CKD) based on different estimated glomerular filtration rate (eGFR) equations and to evaluate which definition of CKD best improves cardiovascular risk prediction of the Framingham Cardiovascular Risk Score (Framingham-CV-RS). CKD was defined as eGFR <60 mL/min/1.73 m(2), estimated by the creatinine-based Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations and a cystatin C-based equation (CKD-CysC). Cox regression was used to estimate hazard ratios (HRs) of subjects with CKD for incident cardiovascular events in a cohort of 1,153 individuals with diabetes (baseline age 50-74 years). Furthermore, the CKD definitions were added individually to a reference model comprising the Framingham-CV-RS variables and HbA(1c), and measures of model discrimination and reclassification were assessed. During 5 years of follow-up, 95 individuals had a primary cardiovascular event. Crude HRs were increased for all CKD definitions. However, after adjusting for established cardiovascular risk factors, HRs for both creatinine-based CKD definitions were attenuated to point estimates of 1.03, whereas th...Continue Reading

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Citations

Aug 6, 2013·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Christine K LiuJoanne M Murabito
Jan 4, 2013·Scandinavian Journal of Clinical and Laboratory Investigation·Eva GravesenKlaus Olgaard
Feb 24, 2016·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Christian Mende, Arie Katz
Oct 9, 2014·Gerodontology·Masanori IwasakiHideo Miyazaki
Jan 27, 2015·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Insa E EmrichGunnar H Heine
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Mar 1, 2015·Expert Review of Endocrinology & Metabolism·Jayne Smith-PalmerJay P Bae

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SAS

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