Comparison between four equations for the estimation of glomerular filtration rate in predicting future cardiovascular events and the existing peripheral arterial disease

Abstract

Chronic kidney disease (CKD) defined as a glomerular filtration rate (GFR) < 60 ml/min/1,73 m 2 is recognized as a risk factor of cardiovascular (CV) diseases. However, the choice of the best equation for the estimation of GFR in predicting future CV events in type 2 diabetes (T2D) is debated. We aimed to compare 4 GFR equations in predicting future CV events in T2D. Four equations were used to calculate GFR in asymptomatic T2D patients consulting between 2007 and 2016 in our establishment for a CV assessment. Cox proportional hazard ratio was used to build and compare prediction models for each equation. Among 796 asymptomatic T2D patients, the prevalence of CKD was 18% (MDRD and CKD-EPI), 13% (CG-SC) and 11% (CG). The 5-year incidence of CV events was 8% ( n = 63). After adjustment on covariables, CKD was associated with CV events when defined by MDRD (HRa = 2,10[1,17-3,78]) and CKD-EPI (HRa = 1,95[1,07-3,52]) but not for the other 2 formulas. Furthermore, only the prediction models including MDRD and CKD-EPI (with equal performance) provided significant information to the model without GFR ( P < 0,05). In this asymptomatic T2D population, we have found that MDRD and CKD-EPI equations can equally predict the cardiovascular events occurrence.