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

Autor: Richard J MacIsaac, Anna J Wood, Nayomi Perera, Elif I Ekinci, Leonid Churilov, George Jerums, David P. Thomas, Aurora M T Poon
Rok vydání: 2015
Předmět:
Male
medicine.medical_specialty
Outpatient Clinics
Hospital
Victoria
Intraclass correlation
Endocrinology
Diabetes and Metabolism
030232 urology & nephrology
Urology
Renal function
Type 2 diabetes
Kidney
Severity of Illness Index
Tertiary Care Centers
03 medical and health sciences
0302 clinical medicine
Endocrinology
Hospitals
Urban
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Outpatient clinic
Humans
Diabetic Nephropathies
030212 general & internal medicine
Longitudinal Studies
Renal Insufficiency
Chronic
Retrospective Studies
Sex Characteristics
business.industry
medicine.disease
Renal Elimination
Blood pressure
Diabetes Mellitus
Type 2
Injections
Intravenous
Albuminuria
Disease Progression
Technetium Tc 99m Pentetate
Female
medicine.symptom
Radiopharmaceuticals
business
Algorithms
Kidney disease
Glomerular Filtration Rate
Zdroj: Journal of diabetes and its complications. 30(1)
ISSN: 1873-460X
Popis: 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 11years (IQR: 9, 12). The difference between mGFR and eGFR increased proportionally to the magnitude of the GFR, increasing by 0.2ml/min/1.73m 2 for every 1ml/min/1.73m 2 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 60ml/min/1.73m 2 . The association between LDL cholesterol, triglycerides, HbA1c, diastolic blood pressure and the difference between mGFR and eGFR warrants further study.
Databáze: OpenAIRE
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