Journal Article

Introduction of the CKD-EPI equation to estimate glomerular filtration rate in a Caucasian population

Jan A.J.G. van den Brand, Gerben A.J. van Boekel, Hans L. Willems, Lambertus A.L.M. Kiemeney, Martin den Heijer and Jack F.M. Wetzels

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 26, issue 10, pages 3176-3181
Published in print October 2011 | ISSN: 0931-0509
Published online February 2011 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfr003
Introduction of the CKD-EPI equation to estimate glomerular filtration rate in a Caucasian population

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Background. Chronic kidney disease (CKD) is defined as the presence of kidney damage, albuminuria or a reduction in glomerular filtration rate (GFR). A GFR <60 mL/min/1.73m2 alone is sufficient to diagnose CKD Stages III–V. Recently, the new chronic kidney disease epidemiology collaboration (CKD-EPI) equation was introduced. It has been suggested to result in higher estimated glomerular filtration rates (eGFRs) than the Modification of Diet in Renal Disease (MDRD4) formula. Here, we assess consequences of introducing the CKD-EPI equation in a West European Caucasian population.

Methods. Data were obtained from 6097 Caucasian participants of the Nijmegen Biomedical Study (2823 males and 3274 females). Serum creatinine values were determined using the Jaffe method, calibrated against mass spectrometry and were used to calculate eGFRMDRD4 and eGFRCKD-EPI. Demographic data, health status and information on medication use for all participants was obtained with a postal questionnaire.

Results. The introduction of the CKD-EPI equation changed the curve of eGFR by age, with higher values in the younger age groups and a steeper decline of eGFR with ageing. As a consequence, younger people were more often classified to a higher GFR stage and older people, especially males, to a lower GFR stage.

Conclusions. In comparison with the MDRD4 formula, the CKD-EPI equation leads to higher estimates of GFR in young people and lower estimates in the elderly. On a population level, this may lead to higher estimates of kidney function. However, in routine clinical practice where the population is predominantly elderly, the opposite may be true. The introduction of eGFRCKD-EPI necessitates reconsidering the definition of CKD. We suggest introducing age-dependent threshold values and/or the use of urinary albumin excretion to improve risk stratification.

Keywords: chronic kidney disease; epidemiology; glomerular filtration rate

Journal Article.  2271 words.  Illustrated.

Subjects: Nephrology

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