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Performance of 4 Creatinine-based Equations in Assessing Glomerular Filtration Rate in Adults with Diabetes.
- Source :
- Journal of Clinical Endocrinology & Metabolism; Jan2021, Vol. 106 Issue 1, pe61-e73, 13p
- Publication Year :
- 2021
-
Abstract
- <bold>Aims: </bold>To evaluate diagnostic performance of glomerular filtration rate (GFR) estimated by modification of diet in renal disease (MDRD), chronic kidney disease epidemiology collaboration (CKD-EPI), full age spectrum (FAS), and revised Lund-Malmö (r-LM) equations in adults with diabetes.<bold>Methods: </bold>Individuals were included in this cross-sectional study if they had at least 1 measurement of technetium-99m diethylenetriamine-pentaacetic acid (99mTc-DTPA) GFR (mGFR) and serum creatinine (1487 patients with 2703 measures). GFR calculated by estimation equations was compared with mGFR. Diagnostic performance was assessed using concordance correlation coefficient (CCC), bias, precision, accuracy, reduced major axis regression (RMAR), and Bland-Altman plot. Analysis was repeated in subgroups based on sex, diabetes type, Hemoglobin A1C, and GFR level.<bold>Results: </bold>Of all patients, 1189 (86%) had type 2 diabetes. Mean mGFR, MDRD, CKD-EPI, FAS, and revised Lund-Malmö eGFR were 66, 72, 74, 71, and 67 mL/min/1.73m2, respectively. Overall, the r-LM had the highest CCC (0.83), lowest bias (-1.4 mL/min/1.73 m2), highest precision (16.2 mL/min/1.73 m2), and highest accuracy (P10 = 39%). The RMAR (slope, intercept) in r-LM, FAS, MDRD, and CKD-EPI was 1.18, -13.35; 0.97, -2.9; 1, -6.4, and 1.04, -11.3, respectively. The Bland-Altman plot showed that r-LM had the lowest mean difference and the narrowest 95% limit of agreement (-1.0, 54.1 mL/min/1.73 m2), while mean difference was more than 5-fold higher in FAS, MDRD, and CKD-EPI (-5.2, -6.3, and -8.2, respectively).<bold>Conclusions: </bold>In adults with diabetes the revised Lund-Malmö performs better than MDRD, CKD-EPI, and FAS in calculating point estimates of GFR. [ABSTRACT FROM AUTHOR]
- Subjects :
- CREATININE
GLOMERULAR filtration rate
TYPE 2 diabetes
BLAND-Altman plot
ADULTS
CHRONIC kidney failure
DIAGNOSIS of diabetes
RESEARCH
RESEARCH evaluation
PREDICTIVE tests
MATHEMATICAL models
RESEARCH methodology
DIABETES
MEDICAL cooperation
EVALUATION research
COMPARATIVE studies
THEORY
DIABETIC nephropathies
ALGORITHMS
Subjects
Details
- Language :
- English
- ISSN :
- 0021972X
- Volume :
- 106
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Clinical Endocrinology & Metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 147866916
- Full Text :
- https://doi.org/10.1210/clinem/dgaa722