For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
25
views
14
references
 Top references
cited by
37
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      292
      similar
       All similar

      Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

      Submit here before September 30, 2024

      About Blood Purification: 3.0 Impact Factor I 5.6 CiteScore I 0.83 Scimago Journal & Country Rank (SJR)

      • Record: found
      • Abstract: found
      • Article: found

      Creatinine Fluctuation Has a Greater Effect than the Formula to Estimate Glomerular Filtration Rate on the Prevalence of Chronic Kidney Disease

      research-article

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background/Aims: Cases of chronic kidney disease (CKD) are defined by the estimated glomerular filtration rate (eGFR), calculated using the Modified Diet in Renal Disease (MDRD) or, more recently, the CKD Epidemiology Collaboration (CKD-EPI) formula. This study set out to promote a systematic approach to reporting CKD prevalence. Design, Setting, Participants and Measurements: The study explores the impact of the way in which eGFR is calculated on the prevalence of CKD. We took into account whether including (1) ethnicity, (2) using a single eGFR, (3) using more than 1 eGFR value or (4) using the CKD-EPI formula affected the estimates of prevalence. Sample: Of 930,997 registered patients, 36% (332,891) have their eGFR defined (63% of those aged 50–74 years, 81% >75 years). Results: The prevalence of stage 3–5 CKD is 5.41% (n = 50,331). (1) Not including ethnicity data the prevalence would be 5.49%, (2) just using the latest eGFR 6.4%, (3) excluding intermediary values 5.55% and (4) using the CKD-EPI equation 4.8%. All changes in eGFR (t test) and the proportion with CKD (χ<sup>2</sup> test) were significant (p < 0.001). Using serum-creatinine-calculated eGFR instead of laboratory data reduced the prevalence of stage 3–5 CKD by around 0.01%. Sixty-six percent of people with stage 3–5 disease have cardiovascular disease and 4.0% significant proteinuria using the MDRD formula; the corresponding figures using CKD-EPI are 74 and 4.6%. Conclusions: A standardised approach to reporting case finding would allow a better comparison of prevalence estimates. Using a single eGFR tends to inflate the reported prevalence of CKD by ignoring creatinine fluctuation; this effect is greater than the difference between MDRD and CKD-EPI.

          Related collections

          Most cited references14

          • Record: found
          • Abstract: found
          • Article: not found

          Chronic kidney disease management in the United Kingdom: NEOERICA project results.

          N Hague, Jochem van der Voort van Zyp, R. Middleton … (2007)
          Early identification of patients with chronic kidney disease (CKD) may allow health-care systems to implement interventions aimed at decreasing disease progression and eventual morbidity and mortality. Primary care in the United Kingdom is computerized suggesting a separate screening program for CKD may not be necessary because identifying data already populates primary care databases. Our study utilized a data set of 163 demographic, laboratory, diagnosis, and prescription variables from 130 226 adults in the regions of Kent, Manchester, and Surrey. The patients were 18 years of age and older in a 5-year study period culminating in November 2003. Estimated glomerular filtration rate was calculated from the four-variable Modification of Diet in Renal Disease equation using calibrated creatinine levels. A valid creatinine value was recorded in almost 30% of this cohort. The age-standardized prevalence of stage 3-5 CKD was 10.6% for females and 5.8% for males. In these patients, the odds ratio for hypertension was 2.1, for diabetes 1.33, and for cardiovascular disease 1.69. Only 20% of the diabetic people with stage 3-5 CKD had a blood pressure less than or equal to 130/80 mm Hg. The proportion of patients with anemia significantly rose as renal function declined. We suggest that stage 3-5 CKD is easily detected in existing computerized records. The associated comorbidity and management is readily available enabling intervention and targeting of specialist resources.
          Article 0 comments Cited 124 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The use of routinely collected computer data for research in primary care: opportunities and challenges.

            Simon de Lusignan, Chris Weel (2006)
            Routinely collected primary care data has underpinned research that has helped define primary care as a specialty. In the early years of the discipline, data were collected manually, but digital data collection now makes large volumes of data readily available. Primary care informatics is emerging as an academic discipline for the scientific study of how to harness these data. This paper reviews how data are stored in primary care computer systems; current use of large primary care research databases; and, the opportunities and challenges for using routinely collected primary care data in research. (1) Growing volumes of routinely recorded data. (2) Improving data quality. (3) Technological progress enabling large datasets to be processed. (4) The potential to link clinical data in family practice with other data including genetic databases. (5) An established body of know-how within the international health informatics community. (1) Research methods for working with large primary care datasets are limited. (2) How to infer meaning from data. (3) Pace of change in medicine and technology. (4) Integrating systems where there is often no reliable unique identifier and between health (person-based records) and social care (care-based records-e.g. child protection). (5) Achieving appropriate levels of information security, confidentiality, and privacy. Routinely collected primary care computer data, aggregated into large databases, is used for audit, quality improvement, health service planning, epidemiological study and research. However, gaps exist in the literature about how to find relevant data, select appropriate research methods and ensure that the correct inferences are drawn.
            Article 0 comments Cited 101 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              CKD and mortality risk in older people: a community-based population study in the United Kingdom.

              Adrian Mylne, Kathlyn E Fletcher, Liam Smeeth … (2009)
              The prevalence of chronic kidney disease (CKD) increases with age; however, the prognostic significance in older people is uncertain. This study aims to determine the association of CKD with all-cause and cardiovascular mortality in community-dwelling older people 75 years and older. Cohort study of people 75 years and older recruited in 1994 to 1999 to 1 arm of a trial of multidimensional health assessment with mortality follow-up. 53 general practices in Great Britain. 15,336 (73%) of those eligible participated. 13,177 (86%) had serum creatinine measured at baseline. Estimated glomerular filtration rate (eGFR). All-cause and cardiovascular mortality. eGFR derived from serum creatinine level using the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation in milliliters per minute per 1.73 m(2); dipstick proteinuria. Mortality by linkage to national death registration and death certification. After a median follow-up of 7.3 years (interquartile range, 5.0), 7,633 (58%) had died, 42% of cardiovascular causes. In the first 2 years of follow-up, adjusted hazard ratios for all-cause mortality in eGFR bands of 45 to 59, 30 to 44, and less than 30 compared with eGFR greater than 60 mL/min/1.73 m(2) were 1.13 (95% confidence interval, 0.93 to 1.37), 1.69 (95% confidence interval, 1.26 to 2.28), and 3.87 (95% confidence interval, 2.78 to 5.38) in men and 1.14 (95% confidence interval, 0.93 to 1.40), 1.33 (95% confidence interval, 1.06 to 1.68), and 2.44 (95% confidence interval, 1.68 to 3.56) in women, respectively. Hazard ratios were greater for cardiovascular mortality and lower after 2 years. Dipstick proteinuria was independently associated with all-cause, but not cardiovascular, mortality risk in both sexes. Single serum creatinine measurement, no calibration of serum creatinine, MDRD Study equation not validated in older people. As kidney function decreases, there is a graded and independent increase in all-cause and cardiovascular mortality risk in older people 75 years and older, especially in men and those with eGFR less than 45 mL/min/1.73 m(2). Dipstick proteinuria did not add to cardiovascular mortality risk in this elderly population. In older people, identification and management of CKD should prioritize the smaller numbers with more severe CKD.
              Article 0 comments Cited 45 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (publisher-id): NEC
                Journal ID (nlm-ta): Nephron Clin Pract
                Journal ID (doi): 10.1159/issn.1660-2110
                Title: Nephron Clinical Practice
                Publisher: S. Karger AG
                ISSN (Electronic): 1660-2110
                Publication date Subscription-year: 2011
                Publication date (Print): February 2011
                Publication date (Electronic): 31 August 2010
                Volume: 117
                Issue: 3
                Pages: c213-c224
                Affiliations
                aDivision of Community Health Sciences, St. George’s, University of London, London, bDepartment of Renal Medicine, Southmead Hospital, Bristol, cJohn Walls Renal Unit, Leicester General Hospital, University Hospitals of Leicester, Leicester, and dSW Thames Renal Unit, St. Helier Hospital, Carshalton, UK
                Author notes
                *Simon de Lusignan, Division of Community Health Sciences, Hunter Wing, St. George’s University of London, London SW17 0RE (UK), Tel. +44 20 8725 5661, Fax +44 20 8725 3584, E-Mail slusigna@sgul.ac.uk
                Article
                Publisher ID: 320341 Other ID: Nephron Clin Pract 2011;117:c213–c224
                DOI: 10.1159/000320341
                PubMed ID: 20805694
                SO-VID: 0f1311bd-39eb-482f-b31b-3ab166d88858
                Copyright © © 2010 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 03 March 2010
                Date accepted : 29 May 2010
                Page count
                Figures: 3, Tables: 8, References: 31, Pages: 12
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Cardiovascular Medicine,Nephrology
                Keywords: Chronic kidney disease,Creatinine fluctuation,Glomerular filtration rate
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine, Nephrology
                Keywords: Chronic kidney disease, Creatinine fluctuation, Glomerular filtration rate

                Comments

                Comment on this article

                scite_

                Similar content292

                See all similar

                Cited by37

                See all cited by

                Most referenced authors206

                See all reference authors