Evaluation and application of estimation of glomerular filtration rate based on serum creatinine and cystatin C in renal function staging
10.3760/cma.j.issn.0254-6450.2017.11.024
- VernacularTitle:基于肌酐与胱抑素的肾小球滤过率估算方程对人群肾功能分期的评价及应用
- Author:
Zhixiang SHEN
1
;
Yu LIU
;
Min LIU
;
Hui ZHENG
;
Xiaojun WU
;
Chong SHEN
Author Information
1. 江苏省老年医院健康管理中心
- Keywords:
Glomerular filtration rate;
Chronic kidney disease;
Epidemiology
- From:
Chinese Journal of Epidemiology
2017;38(11):1557-1562
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the accordance of chronic kidney disease (CKD) staging between the CKD-EPI2009 equation, the CKD-EPI2012 equation and the modification of diet in renal disease (MDRD) equation and compare the predictive value of common cardiovascular disease. Methods A total of 11151 adults from Jurong area, Jiangsu province, were surveyed from September to November in 2015 and their serum creatinine and cystatin C were detected. The glomerular filtration rate (GFR) was estimated by three equations. Results In the individuals with history of chronic renal insufficiency, the results of CKD staging of CKD-EPI2009 equation and CKD-EPI2012 equation were all consistent with that of MDRD equation (P<0.001), and the consistence between CKD-EPI2012 equation and CKD-EPI2009 equation was even higher. In the people without history of CKD, the results of CKD staging of CKD-EPI2009 equation and CKD-EPI2012 equation were also highly consistent with the results of MDRD equation (P<0.001) and Ka ppa values were 0.662 and 0.654 respectively whilst the results of CKD staging estimated by CKD-EPI2012 equation and MDRD equation were only moderately consistent (Ka ppa=0.436, P<0.001). In the whole observational population, the CKD staging results of MDRD equation, CKD-EPI2009 equation and CKD-EPI2012 equation had a good consistency evaluated by Band-Altman method. The consistency of CKD staging between CKD-EPI (2009, 2012) equation and MDRD equation was higher in ≥70 years old group than that in<70 years old group as well as in males than in females. For predicting hypertension, the AUCs of CKD-EPI equations calculated GFRs were significantly higher than that of MDRD equation;the AUCs of CKD-EPI2012 equation calculated GFR for predicting stroke and coronary heart disease were higher than that of MDRD equations whereas no significant difference in GFR prediction result was found between CKD-EPI2009 equation and MDRD equation. Conclusion MDRD equation and CKD-EPI equation for GFR estimation have high consistency in CKD staging whilst the predictive value of chronic cardiovascular disease by CKD-EPI equation estimated GFR was higher than that of MDRD equation.
