Abstract
BackgroundKidney disease improving global outcomes provided a new classification for chronic kidney disease (CKD) by subdividing the G3 stage into G3a and G3b stages based on glomerular filtration rate (GFR) in 2012. Currently, a few methods are used to evaluate GFR, including measured GFR (mGFR) and estimated GFR (eGFR). One of the mGFR was 99mTc-DTPA scintigraphy method and eGFR using GFR equations were used clinically. Equations were modification of diet in renal disease (MDRD), chronic kidney disease epidemiology collaboration (CKD-EPI), and Chinese adapted MDRD (C-MDRD). This study assessed the accuracy of three different equations for estimated glomerular filtration rate (eGFR) with mGFR using DTPA scintigraphy method as the standard in a population of Chinese chronic kidney disease patients at the G3a stage.ResultsOne hundred and twenty-two patients (age 52.0 ± 15.6 years, 69 were male) were determined as CKD stage 3 based on mGFR. Patients were divided into G3a (47 patients) and G3b (75 patients) subgroups. Bias between eGFR for CKD-EPI and reference mGFR was 0.92 mL/min and 95% limits of agreement was −38.82 to 40.67 mL/min. Bias between eGFR for C-MDRD and mGFR was 3.76 and 95% limits of agreement was −39.32 to 46.85 mL/min. Bias between eGFR for MDRD and mGFR was 3.53 and 95% limits of agreement was −43.35 to 50.4 mL/min. The CKD-EPI equation showed better diagnostic value with a greater area under the receiver operating characteristic curve (AUC: 0.763). AUC for MDRD and C-MDRD were 0.75 and 0.757, respectively.ConclusionsThere were no obvious advantages in accuracy, sensitivity, and specificity for the diagnosis of patients at the G3a stage using the CKD-EPI equation.
Highlights
Kidney disease improving global outcomes provided a new classification for chronic kidney disease (CKD) by subdividing the G3 stage into G3a and G3b stages based on glomerular filtration rate (GFR) in 2012
There were no obvious advantages in accuracy, sensitivity, and specificity for the diagnosis of patients at the G3a stage using the chronic kidney disease epidemiology collaboration (CKD-EPI) equation
In 2012, kidney disease improving global outcomes provided a new classification for chronic kidney disease (CKD) by subdividing the G3 stage into G3a and G3b stages based on glomerular filtration rate (GFR)
Summary
Kidney disease improving global outcomes provided a new classification for chronic kidney disease (CKD) by subdividing the G3 stage into G3a and G3b stages based on glomerular filtration rate (GFR) in 2012. This study assessed the accuracy of three different equations for estimated glomerular filtration rate (eGFR) with mGFR using DTPA scintigraphy method as the standard in a population of Chinese chronic kidney disease patients at the G3a stage. MGFR is determined by analysis of the clearance of some exogenous markers, such as inulin, or of alternative exogenous markers, such as iothalamate, EDTA, diethylene triamine pentaacetic acid (DTPA), and iohexol These methods are, invasive, inconvenient, and expensive, and are unsuitable for use in routine clinical practice [3]. The most commonly used creatinine-based formulas include modification of diet in renal disease (MDRD) [4], chronic kidney disease epidemiology collaboration (CKD-EPI) [5], and the Chinese adapted MDRD equation (C-MDRD), the latter of which was validated as being more accurate than other MDRD equations for people of Chinese origin [6].
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