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Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes: The eGFR Study

Maple-Brown, Louise J., Ekinci, Elif, Hughes, Jaquelyne T., Chatfield, Mark, Lawton, Paul D., Jones, Graham, Ellis, Andrew, Sinha, Ashim K., Cass, Alan, Hoy, Wendy, O'Dea, Kerin, Jerums, George and MacIsaac, Richard J. (2014). Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes: The eGFR Study. Diabetic Medicine,31(7):829-838.

Document type: Journal Article
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IRMA ID cmartelxPUB124
Title Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes: The eGFR Study
Author Maple-Brown, Louise J.
Ekinci, Elif
Hughes, Jaquelyne T.
Chatfield, Mark
Lawton, Paul D.
Jones, Graham
Ellis, Andrew
Sinha, Ashim K.
Cass, Alan
Hoy, Wendy
O'Dea, Kerin
Jerums, George
MacIsaac, Richard J.
Journal Name Diabetic Medicine
Publication Date 2014
Volume Number 31
Issue Number 7
ISSN 0742-3071   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84897348681
Start Page 829
End Page 838
Total Pages 10
Place of Publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Aims
It has been proposed that the Chronic Kidney Disease Epidemiology Collaboration formula estimates glomerular filtration rate more accurately than the Modification of Diet in Renal Disease formula. With the very high incidence of diabetes and end-stage kidney disease in Indigenous Australians, accurate estimation of glomerular filtration rate is vital in early detection of kidney disease. We aimed to assess the performance of the Chronic Kidney Disease Epidemiology Collaboration, Modification of Diet in Renal Disease and Cockcroft–Gault formulas in Indigenous Australians with and without diabetes.

Methods
Indigenous Australians with (n = 224) or without (n = 340) Type 2 diabetes had a reference glomerular filtration rate measure using plasma disappearance of iohexol (measured glomerular filtration rate) over 4 h. Serum creatinine was measured by an enzymatic method. Performance was assessed by bias (measured glomerular filtration rate – estimated glomerular filtration rate) and accuracy (percentage of estimated glomerular filtration rate within 30% of measured glomerular filtration rate).

Results
The median measured glomerular filtration rate (interquartile range) in participants with or without diabetes was 97 (68–119) and 108 (90–122) ml min−1 1.73 m−2, respectively. The Chronic Kidney Disease Epidemiology Collaboration formula had smaller bias and greater accuracy than the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall, for participants both with and without diabetes. However, for estimated glomerular filtration rate > 90 ml min−1 1.73 m−2, the Chronic Kidney Disease Epidemiology Collaboration formula had greater bias in participants with diabetes, underestimating measured glomerular filtration rate by 7.4 vs. 1.0 ml min−1 1.73 m−2 in those without diabetes. The Chronic Kidney Disease Epidemiology Collaboration formula was less accurate across the whole range of estimated glomerular filtration rates in participants with vs. those without diabetes (87.1% vs. 93.3%).

Conclusions
The Chronic Kidney Disease Epidemiology Collaboration formula outperforms the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall in Indigenous Australians with and without diabetes. However, the Chronic Kidney Disease Epidemiology Collaboration formula has greater bias in people with diabetes compared with those without diabetes, especially in those with normal renal function.
DOI http://dx.doi.org/10.1111/dme.12426   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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