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

被引:25
作者
Wood, Anna J. [1 ]
Churilov, Leonid [2 ,3 ]
Perera, Nayomi [1 ]
Thomas, David [4 ]
Poon, Aurora [4 ]
MacIsaac, Richard J. [5 ,6 ]
Jerums, George [1 ,5 ]
Ekinci, Elif I. [1 ,5 ,7 ]
机构
[1] Austin Hlth Endocrine Ctr, Heidelberg, Vic, Australia
[2] Florey Inst Neurosci & Mental Hlth, Heidelberg, Vic, Australia
[3] RMIT Univ, Melbourne, Vic, Australia
[4] Austin Hlth Nucl Med Dept, Heidelberg, Vic, Australia
[5] Univ Melbourne, Austin Hlth, Dept Med, Melbourne, Vic, Australia
[6] Univ Melbourne, St Vincents Hosp, Dept Endocrinol & Diabet, Melbourne, Vic, Australia
[7] Menzies Sch Hlth Res, Darwin, NT, Australia
基金
澳大利亚国家健康与医学研究理事会;
关键词
Type; 2; diabetes; Renal function; Estimated GFR; CKD-EPI; Measured GFR; CHRONIC KIDNEY-DISEASE; SERUM CREATININE; INDIGENOUS AUSTRALIANS; CARDIOVASCULAR-DISEASE; BODY-MASS; RATE GFR; ALBUMINURIA; ACCURATE; FORMULAS; MDRD;
D O I
10.1016/j.jdiacomp.2015.08.025
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 11 years (IQR: 9,12). The difference between mGFR and eGFR increased proportionally to the magnitude of the GFR, increasing by 02 ml/min/1.73 m(2) for every 1 ml/min/1.73 m(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 60 ml/min/1.73 m(2). The association between LDL cholesterol, triglycerides, HbA1c, diastolic blood pressure and the difference between mGFR and eGFR warrants further study. (C) 2016 Published by Elsevier Inc.
引用
收藏
页码:49 / 54
页数:6
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