Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/18566
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dc.contributor.authorMacIsaac, Richard J-
dc.contributor.authorEkinci, Elif I-
dc.contributor.authorPremaratne, Erosha-
dc.contributor.authorLu, Zhong X-
dc.contributor.authorSeah, Jas-Mine-
dc.contributor.authorLi, Yue-
dc.contributor.authorBoston, Ray-
dc.contributor.authorWard, Glenn M-
dc.contributor.authorJerums, George-
dc.date2015-12-03-
dc.date.accessioned2018-08-30T06:23:38Z-
dc.date.available2018-08-30T06:23:38Z-
dc.date.issued2015-12-03-
dc.identifier.citationBMC nephrology 2015; 16: 198-
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/18566-
dc.description.abstractOur hypothesis was that both the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations would underestimate directly measured GFR (mGFR) to a similar extent in people with diabetes and preserved renal function. In a cross-sectional study, bias (eGFR - mGFR) was compared for the CKD-EPI and MDRD equations, after stratification for mGFR levels. We also examined the ability of the CKD-EPI compared with the MDRD equation to correctly classify subjects to various CKD stages. In a longitudinal study of subjects with an early decline in GFR i.e., initial mGFR > 60 ml/min/1.73 m(2) and rate of decline in GFR (ΔmGFR) > 3.3 ml/min/1.73 m(2) per year, ΔmGFR (based on initial and final values) was compared with ΔeGFR by the CKD-EPI and MDRD equations over a mean of 9 years. In the cross-sectional study, mGFR for the whole group was 80 ± 2.2 ml/min/1.73 m(2) (n = 199, 75 % type 2 diabetes). For subjects with mGFR >90 ml/min/1.73 m(2) (mGFR: 112 ± 2.0, n = 76), both equations significantly underestimated mGFR to a similar extent: bias for CKD-EPI: -12 ± 1.4 ml/min/1.73 m(2) (p < 0.001) and for MDRD: -11 ± 2.1 ml/min/1.73 m(2) (p < 0.001). Using the CKD-EPI compared with the MDRD equation did not improve the number of subjects that were correctly classified to a CKD-stage. No biochemical or clinical patient characteristics were identified to account for the under estimation of mGFR values in the normal to high range by the CKD-EPI equation. In the longitudinal study (n = 30, 66 % type 1 diabetes), initial and final mGFR values were 102.8 ± 6 and 54.6 ± 6.0 ml/min/1.73 m(2), respectively. Mean ΔGFR (ml/min/1.73 m(2) per year) was 6.0 by mGFR compared with only 3.0 by MDRD and 3.2 by CKD-EPI (both p < 0.05 vs mGFR) CONCLUSIONS: Both the CKD-EPI and MDRD equations underestimate reference GFR values > 90 ml/min/1.73 m(2) as well as an early decline in GFR to a similar extent in people with diabetes. There is scope to improve methods for estimating an early decline in GFR.-
dc.language.isoeng-
dc.titleThe Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation does not improve the underestimation of Glomerular Filtration Rate (GFR) in people with diabetes and preserved renal function.-
dc.typeJournal Article-
dc.identifier.journaltitleBMC nephrology-
dc.identifier.affiliationDepartment of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Medicine, St Vincent's Hospital, University of Melbourne, Fitzroy, 3065, Victoria, Australiaen
dc.identifier.affiliationEndocrine Centre, Heidelberg Repatriation Hospital, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, 4th Floor, Daly Wing, 35 Victoria Parade, PO Box 2900, Fitzroy, VIC, 3065, Australiaen
dc.identifier.affiliationMenzies School of Health Research, Casuarina, 0811, Northern Territory, Australiaen
dc.identifier.affiliationDepartment of Medicine, Austin Health, University of Melbourne, Heidelberg, 3084, Victoria, Australiaen
dc.identifier.affiliationMelbourne Pathology, Collingwood, 3066, Victoria, Australiaen
dc.identifier.affiliationClinical Chemistry, St Vincent's Hospital Melbourne, Fitzroy, 3065, Victoria, Australiaen
dc.identifier.doi10.1186/s12882-015-0196-0-
dc.identifier.orcid0000-0003-2372-395X-
dc.identifier.pubmedid26630928-
dc.type.austinJournal Article-
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