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      Accuracy of glomerular filtration rate equations for chronic kidney disease patients at the G3a stage: a single-center cross-sectional study

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          Abstract

          Background

          Kidney disease improving global outcomes provided a new classification for chronic kidney disease (CKD) by subdividing the G3 stage into G3a and G3b stages based on glomerular filtration rate (GFR) in 2012. Currently, a few methods are used to evaluate GFR, including measured GFR (mGFR) and estimated GFR (eGFR). One of the mGFR was 99mTc-DTPA scintigraphy method and eGFR using GFR equations were used clinically. Equations were modification of diet in renal disease (MDRD), chronic kidney disease epidemiology collaboration (CKD-EPI), and Chinese adapted MDRD (C-MDRD). This study assessed the accuracy of three different equations for estimated glomerular filtration rate (eGFR) with mGFR using DTPA scintigraphy method as the standard in a population of Chinese chronic kidney disease patients at the G3a stage.

          Results

          One hundred and twenty-two patients (age 52.0 ± 15.6 years, 69 were male) were determined as CKD stage 3 based on mGFR. Patients were divided into G3a (47 patients) and G3b (75 patients) subgroups. Bias between eGFR for CKD-EPI and reference mGFR was 0.92 mL/min and 95% limits of agreement was −38.82 to 40.67 mL/min. Bias between eGFR for C-MDRD and mGFR was 3.76 and 95% limits of agreement was −39.32 to 46.85 mL/min. Bias between eGFR for MDRD and mGFR was 3.53 and 95% limits of agreement was −43.35 to 50.4 mL/min. The CKD-EPI equation showed better diagnostic value with a greater area under the receiver operating characteristic curve (AUC: 0.763). AUC for MDRD and C-MDRD were 0.75 and 0.757, respectively.

          Conclusions

          There were no obvious advantages in accuracy, sensitivity, and specificity for the diagnosis of patients at the G3a stage using the CKD-EPI equation.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13104-017-2400-8) contains supplementary material, which is available to authorized users.

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          Most cited references5

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          Assessing glomerular filtration rate in hospitalized patients: a comparison between CKD-EPI and four cystatin C-based equations.

          A specific method is required for estimating glomerular filtration rate GFR in hospitalized patients. Our objective was to validate the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and four cystatin C (CysC)-based equations in this setting. This was an epidemiologic, cross-sectional study in a random sample of hospitalized patients (n = 3114). We studied the accuracy of the CKD-EPI and four CysC-based equations--based on (1) CysC alone or (2) adjusted by gender; (3) age, gender, and race; and (4) age, gender, race, and creatinine, respectively--compared with GFR measured by iohexol clearance (mGFR). Clinical, biochemical, and nutritional data were also collected. The CysC equation 3 significantly overestimated the GFR (bias of 7.4 ml/min per 1.73 m(2)). Most of the error in creatinine-based equations was attributable to calculated muscle mass, which depended on patient's nutritional status. In patients without malnutrition or reduced body surface area, the CKD-EPI equation adequately estimated GFR. Equations based on CysC gave more precise mGFR estimates when malnutrition, extensive reduction of body surface area, or loss of muscle mass were present (biases of 1 and 1.3 ml/min per 1.73 m(2) for equations 2 and 4, respectively, versus 5.9 ml/min per 1.73 m(2) for CKD-EPI). These results suggest that the use of equations based on CysC and gender, or CysC, age, gender, and race, is more appropriate in hospitalized patients to estimate GFR, since these equations are much less dependent on patient's nutritional status or muscle mass than the CKD-EPI equation.
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            • Article: not found

            CKD stage at nephrology referral and factors influencing the risks of ESRD and death.

            Patients with chronic kidney disease (CKD) stages 3-5 are at increased risk of progressing to end-stage renal disease (ESRD) or dying prior to the development of ESRD compared with patients with less severe CKD. The magnitude of these risks may vary by stage, which has important implications for therapy. Our objective was to apply a competing risk analysis in order to estimate these risks in a referred cohort of patients with CKD by stage at referral and identify risk factors associated with each outcome.
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              Comparisons of technetium-99m diethylenetriaminepentaacetic acid plasma clearance and renal dynamic imaging with inulin clearance.

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                Author and article information

                Contributors
                douyanna1982@126.com
                sunxiran19920208@163.com
                liudong030@163.com
                zhanglishuyao@163.com
                vxiaojing5123@139.com
                chengrooter@163.com
                d.yu@keele.ac.uk
                zhanzhengzhao@zzu.edu.cn , 13938525666@139.com
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                24 February 2017
                24 February 2017
                2017
                : 10
                : 107
                Affiliations
                [1 ]GRID grid.412633.1, , The Nephrology Center of the First Affiliated Hospital of Zhengzhou University, ; Zhengzhou, China
                [2 ]ISNI 0000 0001 2189 3846, GRID grid.207374.5, , Zhengzhou University Institute of Nephrology, ; Zhengzhou, China
                [3 ]ISNI 0000 0004 0415 6205, GRID grid.9757.c, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, , Keele University, ; Keele, ST5 5BG UK
                Article
                2400
                10.1186/s13104-017-2400-8
                5399329
                28235417
                84ee7fef-20be-484b-ad6d-40b532178a7b
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 February 2016
                : 24 January 2017
                Funding
                Funded by: The Youth Funds from The First Affiliated Hospital of Zhengzhou University
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China ;
                Award ID: U1404804
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Medicine
                g3a stage,glomerular filtration rate equations,accuracy,chronic kidney disease
                Medicine
                g3a stage, glomerular filtration rate equations, accuracy, chronic kidney disease

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