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[Diagnostic ability of Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease-4 equations to estimate glomerular filtration rate in with multimorbidity patients].

Authors
  • Cabrerizo-García, José Luis1
  • Díez-Manglano, Jesús2
  • García-Arilla, Ernesto3
  • Revillo-Pinilla, Paz4
  • Ramón-Puertas, José5
  • Sebastián-Royo, Mariano5
  • 1 Servicio de Medicina Interna, Hospital General de la Defensa, Zaragoza, España. Electronic address: [email protected]
  • 2 Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España.
  • 3 Servicio de Geriatría, Hospital Nuestra Señora de Gracia, Zaragoza, España.
  • 4 Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España.
  • 5 Servicio de Medicina Interna, Hospital General de la Defensa, Zaragoza, España.
Type
Published Article
Journal
Medicina Clínica
Publisher
Elsevier
Publication Date
Jan 06, 2015
Volume
144
Issue
1
Pages
14–20
Identifiers
DOI: 10.1016/j.medcli.2013.09.016
PMID: 24210978
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

The Modification of Diet in Renal Disease (MDRD) equation is recommended by most scientific societies to calculate the estimated glomerular filtration rate (GFR). Recently the group Chronic Kidney Disease Epidemiology Collaboration (CKP-EPI) has published a new, more precise and accurate equation. We have analyzed its behavior in a group of polypathological patients (PP) and compared it with the classic MDRD-4.version Multicenter, observational, descriptive and transversal study. We calculated GFR by MDRD-4 and CKD-EPI in 425 PP. Each stage was assigned according to the GFR: 1:>90; 2: 60-89; 3: 30-59; 4: 15-29; and 5 < 15 ml/min/1.73m(2). We analyzed the correlation between both and the patients reclassified by CKD-EPI. Mean age was (mean [SD]) 81.7 (7.9) years. 55.3% were women. The mean estimated GFR was 58.6 (26.3) ml/min/1,73m(2) by MDRD-4 and 52.7 (23.0) ml/min/1.73m(2) by CKD-EPI (P<.001; Spearman's Rho correlation and Lin concordance coefficients: 0.993 and 0.948). The Bland-Altman plots reflected lower values for GFR for CKD-EPI equation. In the stage 2, 21.2% were reclassified by CKD-EPI to the stage 3, with women older than 83 years being the more disadvantaged subgroup with 27.3% or reclassification. CKD-EPI equation applied to PP worsens the results of MDRD-4. In general, it originates low values of GFR and increases the degree of renal insufficiency, especially in older women. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

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