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Comparison of the heart failure risk stratification performance of the CKD- EPI equation and the MDRD equation for estimated glomerular filtration rate in patients with Type 2 diabetes.
- Source :
-
Diabetic Medicine . May2016, Vol. 33 Issue 5, p609-620. 12p. 4 Charts. - Publication Year :
- 2016
-
Abstract
- Aims To investigate the risk prediction and the risk stratification performances of the Chronic Kidney Disease Epidemiology Collaboration ( CKD- EPI) equation and the Modification of Diet in Renal Disease ( MDRD) equation for estimated glomerular filtration rate ( eGFRCKD- EPI vs. eGFRMDRD) on heart failure in patients with Type 2 diabetes. Methods The study cohort included 12 258 White and 16 886 African American low-income patients with Type 2 diabetes who were 30-90 years old at baseline. Heart failure risk according to different eGFRCKD- EPI and eGFRMDRD categories was prospectively assessed. Results During a mean follow-up of 6.5 years, 5043 incident heart failure cases were identified. Multivariable-adjusted hazard ratios ( HRs) of heart failure associated with the eGFRCKD- EPI categories [≥ 90 (reference group), 75-89, 60-74, 30-59 and < 30 ml/min/1.73 m2] were 1.00, 1.11, 1.31, 1.75 and 2.93 ( Ptrend < 0.001) for African American patients, and 1.00, 1.11, 1.08, 1.59 and 2.92 ( Ptrend < 0.001) for White patients, respectively. The model with eGFRCKD- EPI and the other risk factors had significantly higher Harrell's C than the model with eGFRMDRD and other risk factors. Patients reclassified downward from eGFRMDRD 60-74 to eGFRCKD- EPI 30-59 and from eGFRMDRD 30-59 to eGFRCKD- EPI < 30 ml/min/1.73 m2 showed higher heart failure risk than those who were not reclassified. Conclusions Impaired kidney function (i.e. GFR < 60 ml/min/1.73 m2), and even mildly decreased GFR (60-74 ml/min/1.73 m2) estimated by both equations is associated with an increased risk of heart failure. Compared with GFR estimated using the MDRD equation, GFR estimated using the CKD- EPI equation added more predictive power to the model with the other risk factors. Also, eGFRCKD- EPI provided more accurate heart failure risk stratification than eGFRMDRD . [ABSTRACT FROM AUTHOR]
- Subjects :
- *HEART failure
*KIDNEY disease prevention
*CHRONIC kidney failure
*ANTHROPOMETRY
*CHOLESTEROL
*CONFIDENCE intervals
*CREATININE
*PEOPLE with diabetes
*DIET
*EPIDEMIOLOGY
*ETHNIC groups
*GLOMERULAR filtration rate
*GLYCOSYLATED hemoglobin
*HIGH density lipoproteins
*PATIENT aftercare
*INCOME
*INSURANCE
*LIPOPROTEINS
*LOW density lipoproteins
*MEDICAL care
*MEDICAL care costs
*TYPE 2 diabetes
*NOSOLOGY
*PATIENTS
*POPULATION
*RESEARCH funding
*RISK assessment
*DATA analysis
*MEDICAL coding
*DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 07423071
- Volume :
- 33
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Diabetic Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 114604677
- Full Text :
- https://doi.org/10.1111/dme.12859