Abstract: SA-PO766
Comparisons of Different Equations for Estimated Glomerular Filtration Rate in Chinese Han Patients with CKD in Real World
Session Information
- CKD: Epidemiology, Risk Factors, Prevention - III
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Author
- Mao, Huijuan, First Affiliated Hospital of Nanjing Medical University, Nanjing, JIangSu, China
Background
The currently recognized and most accurate estimate of glomerular filtration rate(eGFR) formula is the creatinine- cystatin C joint formula（EPI_Cr_CysC) developed by the Chronic Kidney Disease Epidemiology Research Group. However, cystatin C( CysC) can not be determined in many cases , so that the wide application of EPI_Cr_CysC formula is limited. The purpose of this study is to study the agreement, precision and accuracy between other eGFR formulas and EPI_Cr_CysC formulas, and to find the best alternative formula for EPI_Cr_CysC.
Methods
We conducted a cross-sectional study research of 1913 CKD patients. The eGFRs were calculated separately by creatinine clearance rate and Cockcroft-Gault equation corrected for standard body surface area (Ccr_BSA and eCcr_BSA), CKD-EPI_creatinine equation (EPI_Cr), CKD-EPI_cystatin C equation (EPI_CysC), EPI_Cr_CysC equation, Modification of Diet in Renal Disease equation with standardized serum creatinine (MDRD) and full-age-spectrum creatinine equation (FAS). And EPI_Cr_CysC equation was used as the reference.
Results
When compared with EPI_Cr_CysC equation, EPI_Cr equation achieved the highest agreement in eGFR estimates [Lin’s concordance correlation coefficient (95%CI), 0.936(0.930, 0.941)]. And eCcr_BSA and EPI_Cr equation achieved the first and second highest percent agreement in accurate classification of the CKD stage [percent agreement,72.55% VS 71.25%]. MDRD equation got the minimal bias and was closely followed by EPI_Cr equation [median difference (95% CI), -1.3(-2.0, -0.8) VS 2.5(1.7,3.3) mL/min/1.73m2]. EPI_CysC and EPI_Cr equations achieved the first and second highest precision [IQR of the difference (95% CI), 12.2(11.6,12.9) VS. 15.5(14.7,16.3) mL/min/1.73m2]. EPI_Cr and MDRD equations performed similarly and tied for first place in 30% accuracy [1-P30 (95% CI),18.6(16.9,20.4) % VS 18.6 (16.8, 20.3) %].
Conclusion
For assessment of renal function, EPI_Cr equation performed the best and remained an acceptable alternative to EPI_Cr_CysC equation in the absence of cystatin C.
Funding
- Government Support - Non-U.S.