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See detailModification of diet in renal disease versus chronic kidney disease epidemiology collaboration equation to estimate glomerular filtration rate in obese patients
BOUQUEGNEAU, Antoine ULg; Vidal-Petiot, Emanuelle; Vrtovsnik, François et al

in Nephrology Dialysis Transplantation (2013), 28(4), 122-130

Background Obesity is a recognized risk factor for both the development and progression of chronic kidney disease (CKD). Accurate estimation of glomerular filtration rate (GFR) is thus important in these ... [more ▼]

Background Obesity is a recognized risk factor for both the development and progression of chronic kidney disease (CKD). Accurate estimation of glomerular filtration rate (GFR) is thus important in these patients. We tested the performances of two creatinine-based GFR estimates, the Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, in an obese population. Methods Patients with body mass index (BMI) > 30 kg/m2 were included. The reference method for measured GFR (mGFR) was 51Cr-EDTA (single-injection method, two blood samples at 120 and 240 min). Both indexed and non-indexed results were considered. Serum creatinine was measured using the IDMS-traceable compensated Jaffe method. Mean bias (eGFR–mGFR), precision (SD around the bias) and accuracy within 30% (percentage of estimations within 30% of mGFR) were calculated for both equations. Results The population included 366 patients (185 women) from two different areas. Mean age was 55 ± 14 years, and mean BMI was 36 ± 7 kg/m2. Mean mGFR was 56 ± 26 mL/min/1.73 m2 (71 ± 35 mL/min without indexation). In the total population, mean bias was +1.9 ± 14.3 and +4.6 ± 14.7 mL/min/1.73 m2 (P < 0.05), and accuracy 30% was 80 and 76% for the MDRD and CKD-EPI equations (P < 0.05), respectively. In patients with mGFR > 60 mL/min/1.73 m2, mean bias was +4.6 ± 18.4 and +9.3 ± 17.2 mL/min/1.73 m2 (P < 0.05), and accuracy 30% was 81 and 79% (NS) for the MDRD and CKD-EPI equations, respectively. Conclusions The CKD-EPI equation did not outperform the MDRD study equation in this population of obese patients [less ▲]

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See detailMDRD Versus CKD_EPI equation to estimate glomerular filtration rate in kidney transplant recipients
masson, Ingrid; Flamant, Martin; Maillard, Nicolas et al

in Transplantation (2013), 95(10),

Background. The new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-based equation was developed to address the systematic underestimation of the glomerular filtration rate (GFR) by ... [more ▼]

Background. The new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-based equation was developed to address the systematic underestimation of the glomerular filtration rate (GFR) by the Modification of Diet in Renal Disease (MDRD) Study equation in patients with a relatively well-preserved kidney function. The performance of the new equation for kidney transplant recipients is discussed. Methods. We analyzed the performances of the CKD-EPI equation in comparison with the MDRD Study equation in 825 stable kidney transplant recipients. Bias, precision, and accuracy within 30% of true GFR were determined. GFR was measured by urinary clearance of inulin (n=488) and plasma clearance of 51Cr-EDTA (n=337). Results. Mean measured GFR (mGFR) was 50T19 mL/min/1.73 m2. On the whole cohort, bias was significantly lower for MDRD Study equation compared with CKD-EPI creatinine. This superiority translates into a better accuracy (80% and 74% for the MDRD and CKD-EPI creatinine, respectively). The best performance of the MDRD Study equation is confirmed both in the subgroups of patients with mGFR G60 mL/min/1.73 m2 and between 60 and 90 mL/min/1.73 m2. For mGFR 990 mL/min/1.73 m2, there were no significant differences between the two equations in terms of performance. Conclusions. The CKD-EPI creatinine equation does not offer a better GFR prediction in renal transplant patients compared with the MDRD Study equation, even in the earlier CKD stages. [less ▲]

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See detailMDRD versus CKD-EPI equation to estimate glomerular filtration rate in kidney transplant recipients
Masson, Ingrid; Flamant, Martin; Maillard, Nicolas et al

in Transplantation (2013), 95(10), 1211-1217

Background. The new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-based equation was developed to address the systematic underestimation of the glomerular filtration rate (GFR) by ... [more ▼]

Background. The new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-based equation was developed to address the systematic underestimation of the glomerular filtration rate (GFR) by the Modification of Diet in Renal Disease (MDRD) Study equation in patients with a relatively well-preserved kidney function. The performance of the new equation for kidney transplant recipients is discussed. Methods. We analyzed the performances of the CKD-EPI equation in comparison with the MDRD Study equation in 825 stable kidney transplant recipients. Bias, precision, and accuracy within 30% of true GFR were determined. GFR was measured by urinary clearance of inulin (n=488) and plasma clearance of 51Cr-EDTA (n=337). Results. Mean measured GFR (mGFR) was 50T19 mL/min/1.73 m2. On the whole cohort, bias was significantly lower for MDRD Study equation compared with CKD-EPI creatinine. This superiority translates into a better accuracy (80% and 74% for the MDRD and CKD-EPI creatinine, respectively). The best performance of the MDRD Study equation is confirmed both in the subgroups of patients with mGFR G60 mL/min/1.73 m2 and between 60 and 90 mL/min/1.73 m2. For mGFR 990 mL/min/1.73 m2, there were no significant differences between the two equations in terms of performance. Conclusions. The CKD-EPI creatinine equation does not offer a better GFR prediction in renal transplant patients compared with the MDRD Study equation, even in the earlier CKD stages. [less ▲]

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See detailCreatinine: Production, Physiology and Diagnostic Use in Kidney Diseases
DELANAYE, Pierre ULg; Vidal-Petiot, Emmanuelle; Flamant, Martin

in Perkins (Ed.) Creatinine: Production, Diagnostic Uses and role in Renal Disease (2012)

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See detailL'estimation du débit de filtration glomérulaire en 2012: quelle valeur ajoutée pour la nouvelle équation CKD-EPI
DELANAYE, Pierre ULg; Mariat, Christophe; Moranne, Olivier et al

in Néphrologie & Thérapeutique (2012), 8

Mesurer ou estimer le debit de filtration glomerulaire (DFG) reste l’un des meilleurs moyens d’apprehender la fonction glomerulaire du rein. En 2009, l’equation Chronic Kidney Disease Epidemiology (CKD ... [more ▼]

Mesurer ou estimer le debit de filtration glomerulaire (DFG) reste l’un des meilleurs moyens d’apprehender la fonction glomerulaire du rein. En 2009, l’equation Chronic Kidney Disease Epidemiology (CKD-EPI) a ete proposee en lieu et place de l’equation Modification of Diet in Renal Disease (MDRD) pour estimer le DFG. Cette nouvelle equation fait partie desormais des toutes dernieres recommandations de la Haute Autorite de sante (HAS). Par rapport a MDRD, la formule CKD-EPI est sensee moins sous-estimer le DFG mesure, principalement dans les valeurs les plus hautes de DFG. Dans cette revue critique de la litterature, nous presenterons et discuterons les performances de cette nouvelle equation. Sur base des articles publies entre 2009 et 2012, nous en soulignerons les avantages, notamment en terme d’estimation de la prevalence de la maladie renale chronique (MRC), mais aussi les faiblesses, principalement dans certaines populations specifiques. En effet, toutes ces equations reposant sur la mesure de la creatinine serique restent des estimations et le nephrologue doit donc garder son sens critique dans l’interpretation de ces resultats. [less ▲]

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