Buscar en
Medicina Clínica (English Edition)
Toda la web
Inicio Medicina Clínica (English Edition) Diagnostic ability of Chronic Kidney Disease Epidemiology Collaboration and Modi...
Journal Information
Vol. 144. Issue 1.
Pages 14-20 (January 2015)
Share
Share
Download PDF
More article options
ePub
Visits
163
Vol. 144. Issue 1.
Pages 14-20 (January 2015)
Original article
DOI: 10.1016/j.medcle.2013.09.001
Diagnostic ability of Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease-4 equations to estimate glomerular filtration rate in with multimorbidity patients
Capacidad diagnóstica de las ecuaciones Chronic Kidney Disease Epidemiology Collaboration y Modification of Diet in Renal Disease-4 en la estimación del filtrado glomerular en pacientes pluripatológicos
Visits
...
José Luis Cabrerizo-Garcíaa,
Corresponding author
j_cabrerizo@hotmail.com

Corresponding author.
, Jesús Díez-Manglanob, Ernesto García-Arillac, Paz Revillo-Pinillad, José Ramón-Puertasa, Mariano Sebastián-Royoa, on behalf of the researchers from the PLUPAR study
a Servicio de Medicina Interna, Hospital General de la Defensa, Zaragoza, Spain
b Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, Spain
c Servicio de Geriatría, Hospital Nuestra Señora de Gracia, Zaragoza, Spain
d Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (4)
Table 1. Sample baseline characteristics.
Table 2. Glomerular filtration rate estimated with the MDRD-4 and CKD-EPI equations. Concordance and correlation study.
Table 3. Bland–Altman concordance analysis for the estimated glomerular filtration values calculated by the CKD-EPI and MDRD-4.
Table 4. Concordances (in boldface) in the classification of glomerular filtration rate groups estimated by the MDRD-4 and CKD-EPI equations, taking the glomerular filtration rate estimated by MDRD-4 as the reference, and simultaneously taking age and sex into account.
Show moreShow less
Abstract
Background and objective

The Modification of Diet in Renal Disease (MDRD) equation is recommended by most scientific societies to calculate the estimated glomerular filtration rate (GFR). Recently the group Chronic Kidney Disease Epidemiology Collaboration (CKP-EPI) has published a new, more precise and accurate equation. We have analysed its behaviour in a group of polypathological patients (PP) and compared it with the classic MDRD-4.version.

Patients and method

Multicenter, observational, descriptive and transversal study. We calculated GFR by MDRD-4 and CKD-EPI in 425 PP. Each stage was assigned according to the GFR: 1: >90; 2: 60–89; 3: 30–59; 4: 15–29; and 5 <15ml/min/1.73m2. We analysed the correlation between both and the patients reclassified by CKD-EPI.

Results

Mean age was (mean [SD]) 81.7 (7.9) years. 55.3% were women. The mean estimated GFR was 58.6 (26.3)ml/min/1.73m2 by MDRD-4 and 52.7 (23.0)ml/min/1.73m2 by CKD-EPI (p<.001; Spearman's Rho correlation and Lin concordance coefficients: 0.993 and 0.948). The Bland–Altman plots reflected lower values for GFR for CKD-EPI equation. In the stage 2, 21.2% were reclassified by CKD-EPI to the stage 3, with women older than 83 years being the more disadvantaged subgroup with 27.3% or reclassification.

Conclusion

CKD-EPI equation applied to PP worsens the results of MDRD-4. In general, it originates low values of GFR and increases the degree of renal insufficiency, especially in older women.

Keywords:
Comorbidity
Glomerular filtration rate
Renal insufficiency
Resumen
Fundamento y objetivo

La fórmula Modification of Diet in Renal Disease (MDRD) es la recomendada por la mayoría de las sociedades científicas para el cálculo del filtrado glomerular estimado (FGe). Recientemente el grupo Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) ha publicado una nueva ecuación con mayor exactitud y precisión. Hemos analizado su comportamiento en un grupo de pacientes pluripatológicos (PP) comparándola con la versión clásica MDRD-4.

Pacientes y método

Estudio multicéntrico, observacional, descriptivo y transversal. Se calculó el FGe por MDRD-4 y CKD-EPI en 425 PP. A cada uno se le asignó un estadio según su FGe: 1: >90; 2: 60-89; 3: 30-59; 4: 15-29; y 5: <15ml/min/1,73 m2. Se analizó la concordancia entre ambas y la reclasificación de pacientes por CKD-EPI.

Resultados

La edad media (DE) fue de 81,7 (7,9) años. El 55,3% eran mujeres. La media del FGe fue de 58,6 (26,3) ml/min/1,73 m2 según MDRD-4 y de 52,7 (23,0) ml/min/1,73 m2 según CKD-EPI (p<0,001; coeficientes de correlación Rho de Spearman y de concordancia de Lin: 0,993 y 0,948, respectivamente). Los gráficos de Bland-Altman reflejaban valores inferiores de FGe para la ecuación CKD-EPI. En el estadio 2, el 21,2% eran reasignados por CKD-EPI al estadio 3, siendo las mujeres mayores de 83 años el subgrupo más desfavorecido, con el 27,3% de reclasificación.

Conclusiones

La CKD-EPI aplicada al cálculo del FGe en PP empeora los resultados de la estimación mediante MDRD-4. Origina, de forma general, valores de FGe inferiores e incrementa el grado de insuficiencia renal, en especial en mujeres más añosas.

Palabras clave:
Comorbilidad
Filtrado glomerular
Insuficiencia renal

Article

These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Clínica (English Edition)

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 22,50 €

Comprar ahora
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.