Comparison of the MDRD and the CKD-EPI equations to estimate the glomerular filtration rate in the general population

Background and objective: The Chronic Kidney Disease Epidemiology Collaboration (CDK-EPI) equation has been proposed as a replacement for the Modification of Diet in Renal Disease (MDRD) equation to estimate the glomerular filtration rate, but this equation has not yet been evaluated in the general population. Patients and methods: Cross-sectional analysis of a random sample of 858 participants from the general population aged 50–75 years without known kidney disease. The prevalence of low eGFR (<60mL/min/1.73m2) was assessed with the MDRD and the CKD-EPI equations in the overall sample and in normoalbuminuric individuals. Results: With the MDRD equation the median eGFRs (interquartile range) in men/women were 63.3(12.2)/56.7(9.4) mL/min/1.73m2, and with the CKD-EPI equation 66.6(14.2)/61.3(11.6) mL/min/1.73m2. The prevalence of low eGFR in men/women was 35.2%/68.5% and 25.1%/45.7% with the MDRD and the CKD-EPI equations, respectively. Normoalbuminuric women without risk factors for CKD experience the most pronounced reduction in the number of cases with low eGFR with the CKD-EPI equation. The prevalence of renal impairment in this subgroup still remained even greater than that in men with diabetes, hypertension, or cardiovascular disease. Conclusions: Compared with the MDRD, the CKD-EPI equation generates a substantial reduction in the prevalence of renal impairment in subjects with diabetes, hypertension, cardiovascular disease, and in subjects without risk factors. The prevalence of renal impairment in normoalbuminuric females may be still overestimated with the CKD-EPI equation (AU)

Fundamento y objetivo: La ecuación Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) ha sido propuesta para sustituir a la actualmente recomendada Modification of Diet in Renal Disease (MDRD) para el cálculo de la tasa de filtrado glomerular (TFG), si bien no ha sido aún evaluada en la población general. Pacientes y Método: Estudio transversal de una muestra aleatoria de 858 individuos de la población general con edades entre 50–75 años sin enfermedad renal conocida. Comparación de la prevalencia de una TFG<60ml/min/1,73m2 calculada con las ecuaciones MDRD y CKD-EPI en toda la muestra y en el subgrupo de individuos normoalbuminúricos (cociente albúmina/creatinina<30mg/g). Resultados: Con la ecuación MDRD la mediana de la TFG (rango intercuartílico) en varones/mujeres fue de 63,3 (12,2)/56,7 (9,4) ml/min/1,73m2, y con la ecuación CKD-EPI 66,6 (14,2)/61,3 (11,6)ml/min/1,73m2, respectivamente. La prevalencia de una TFG baja en varones/mujeres fue del 35,2–68,5%, y del 25,1–45,7% con las ecuaciones MDRD y CKD-EPI, respectivamente. El grupo de mujeres normoalbuminúricas sin factores de riesgo para enfermedad renal crónica presentó la mayor reducción en la prevalencia de una TFG baja con la ecuación CKD-EPI. Sin embargo, la prevalencia en este grupo se mantuvo incluso más elevada que en el de los varones con diabetes, hipertensión o enfermedad cardiovascular. Conclusiones: Comparada con la ecuación MDRD, la ecuación CKD-EPI produce una importante reducción en la prevalencia de insuficiencia renal en individuos con diabetes, hipertensión, enfermedad cardiovascular, y en individuos sin factores de riesgo. La prevalencia de insuficiencia renal en mujeres normoalbuminúricas calculada con la ecuación CKD-EPI puede estar aún sobreestimada (AU)

Comparison of the MDRD and the CKD-EPI equations to estimate the glomerular filtration rate in the general population.

BACKGROUND AND OBJECTIVE: The Chronic Kidney Disease Epidemiology Collaboration (CDK-EPI) equation has been proposed as a replacement for the Modification of Diet in Renal Disease (MDRD) equation to estimate the glomerular filtration rate, but this equation has not yet been evaluated in the general population. PATIENTS AND METHODS: Cross-sectional analysis of a random sample of 858 participants from the general population aged 50-75 years without known kidney disease. The prevalence of low eGFR (< 60 mL/min/1.73 m(2)) was assessed with the MDRD and the CKD-EPI equations in the overall sample and in normoalbuminuric individuals. RESULTS: With the MDRD equation the median eGFRs (interquartile range) in men/women were 63.3(12.2)/56.7(9.4)mL/min/1.73 m(2), and with the CKD-EPI equation 66.6(14.2)/61.3(11.6) mL/min/1.73 m(2). The prevalence of low eGFR in men/women was 35.2%/68.5% and 25.1%/45.7% with the MDRD and the CKD-EPI equations, respectively. Normoalbuminuric women without risk factors for CKD experienced the most pronounced reduction in the number of cases with low eGFR with the CKD-EPI equation. The prevalence of renal impairment in this subgroup still remained even greater than that in men with diabetes, hypertension, or cardiovascular disease. CONCLUSIONS: Compared with the MDRD, the CKD-EPI equation generates a substantial reduction in the prevalence of renal impairment in subjects with diabetes, hypertension, cardiovascular disease, and in subjects without risk factors. The prevalence of renal impairment in normoalbuminuric females may be still overestimated with the CKD-EPI equation.