Applicability evaluation of the GFR equations in Chinese patients with diabetes mellitus complicated with CKD
Objective To explore applicability of Chronic Kidney Disease Epidemiology Collaboration（CKD-EPI）’s glomerular filtration rate（GFR） equations, including modified modification of diet in renal diseases（MDRD） equation, the Feng equation developed for Chinese in recent years, and modified CKD-EPI diabet...
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Editorial Department of Journal of Clinical Nephrology
2019-01-01
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| Series: | Linchuang shenzangbing zazhi |
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| author | LV Xiao-yang ZHONG Liang-bao WANG Shan-zhi ZHU Yong-jun LI xiao-yan |
| author_facet | LV Xiao-yang ZHONG Liang-bao WANG Shan-zhi ZHU Yong-jun LI xiao-yan |
| author_sort | LV Xiao-yang |
| collection | DOAJ |
| description | Objective To explore applicability of Chronic Kidney Disease Epidemiology Collaboration（CKD-EPI）’s glomerular filtration rate（GFR） equations, including modified modification of diet in renal diseases（MDRD） equation, the Feng equation developed for Chinese in recent years, and modified CKD-EPI diabetes equation for Chinese patients with diabetes, in Chinese patients with diabetes mellitus complicated with CKD; furthermore, to provide a more accurate basis for accurate estimation of GFR in patients with diabetes complicated with CKD. Methods A total of 160 patients with type 2 diabetes with CKD were selected. The patient’s data on gender, age, height, weight, blood creatinine（Scr） and cysteine protease inhibitor C（Cys C） were collected. GFR determined by <sup>99 m</sup>Tc-DTPA renal dynamic imaging was used as a reference standard（rGFR）. Modified equations for Chinese patients, including MDRD equation, CKD-EPI<sub>Scr </sub>equation, CKD-EPI<sub>Cys C </sub>equation, CKD-EPI<sub>Scr-Cys C </sub>equation, CKD-EPI diabetes equation, Feng<sub>Cys C </sub>equation and Feng<sub>Scr-Cys C </sub>equation, were used to estimate GFR（eGFR）. Pearson correlation analysis and Kappa test were used to compare the correlation and staged consistency between eGFR and rGFR for each equation. Bland-Altman analysis was used to compare the consistency limits of eGFR and rGFR for each equation. Bias, precision, 10% accuracy, 30% accuracy and 50% accuracy were used to compare eGFR values for each equation. GFR<60 mL·min<sup>-1</sup>·（1.73 m<sup>2</sup>）<sup>-1</sup> was defined as the diagnostic criteria for renal insufficiency, and the performances of various equations for diagnosing renal insufficiency were compared by ROC curve. Patients were divided into group A（CKD stage 4～5）, group B（CKD stage 3）, and group C（CKD stage 1～2） according to the rGFR, and the applicability of various equations in each group was compared. Results In the comparison of eGFR between the equations, the CKD-EPI<sub>diabetes</sub> equation had the smallest bias, with differences of statistical significance compared to Feng<sub>Cys C </sub>equation and Feng Scr-Cys C equation（P<0.05）; it had the highest precision, with differences of statistical significance compared to MDRD equation and CKD-EPI<sub>Cys C </sub>（P<0.05）. In the comparison of accuracy between the 7 equations,, the 10% accuracy and the 30% accuracy of the CKD-EPI<sub>diabetes</sub> equation were the highest, with differences of statistical significance compared to the simplified MDRD equation, CKD-EPI<sub>Scr</sub> equation and CKD-EPI<sub>Cys C</sub> equation（P<0.05）. Bland-Altman analysis showed that CKD-EPI<sub>diabetes</sub> equation had the best consistency limit. In group A, the difference between CKD-EPI<sub>Cys C</sub> equation eGFR and rGFR was not statistically significant, with the least bias, and highest 10% accuracy, 30% accuracy and 50% accuracy. Group B were similar to the overall groups, CKD-EPI<sub>diabetes</sub> equation had the least bias, the highest precision, 10% accuracy, 30% accuracy and 50% accuracy. Conclusions Among the 7 equations, the CKD-EPI<sub>diabetes</sub> equation has the best fit between eGFR and rGFR. In the grouped comparison, the CKD-EPI<sub>Cys C</sub> equation has the best fit in patients with CKD stage 4～5, CKD-EPI<sub>diabetes</sub> equation has the best fit in patients with CKD stage 3. The two equations can be used for estimation of GFR in different groups of patients with diabetes complicated with CKD. |
| format | Article |
| id | doaj-art-86b78a17fd744a03bbc3ad466fce8098 |
| institution | DOAJ |
| issn | 1671-2390 |
| language | zho |
| publishDate | 2019-01-01 |
| publisher | Editorial Department of Journal of Clinical Nephrology |
| record_format | Article |
| series | Linchuang shenzangbing zazhi |
| spelling | doaj-art-86b78a17fd744a03bbc3ad466fce80982025-08-20T03:09:15ZzhoEditorial Department of Journal of Clinical NephrologyLinchuang shenzangbing zazhi1671-23902019-01-011971972657910671Applicability evaluation of the GFR equations in Chinese patients with diabetes mellitus complicated with CKDLV Xiao-yangZHONG Liang-baoWANG Shan-zhiZHU Yong-junLI xiao-yanObjective To explore applicability of Chronic Kidney Disease Epidemiology Collaboration（CKD-EPI）’s glomerular filtration rate（GFR） equations, including modified modification of diet in renal diseases（MDRD） equation, the Feng equation developed for Chinese in recent years, and modified CKD-EPI diabetes equation for Chinese patients with diabetes, in Chinese patients with diabetes mellitus complicated with CKD; furthermore, to provide a more accurate basis for accurate estimation of GFR in patients with diabetes complicated with CKD. Methods A total of 160 patients with type 2 diabetes with CKD were selected. The patient’s data on gender, age, height, weight, blood creatinine（Scr） and cysteine protease inhibitor C（Cys C） were collected. GFR determined by <sup>99 m</sup>Tc-DTPA renal dynamic imaging was used as a reference standard（rGFR）. Modified equations for Chinese patients, including MDRD equation, CKD-EPI<sub>Scr </sub>equation, CKD-EPI<sub>Cys C </sub>equation, CKD-EPI<sub>Scr-Cys C </sub>equation, CKD-EPI diabetes equation, Feng<sub>Cys C </sub>equation and Feng<sub>Scr-Cys C </sub>equation, were used to estimate GFR（eGFR）. Pearson correlation analysis and Kappa test were used to compare the correlation and staged consistency between eGFR and rGFR for each equation. Bland-Altman analysis was used to compare the consistency limits of eGFR and rGFR for each equation. Bias, precision, 10% accuracy, 30% accuracy and 50% accuracy were used to compare eGFR values for each equation. GFR<60 mL·min<sup>-1</sup>·（1.73 m<sup>2</sup>）<sup>-1</sup> was defined as the diagnostic criteria for renal insufficiency, and the performances of various equations for diagnosing renal insufficiency were compared by ROC curve. Patients were divided into group A（CKD stage 4～5）, group B（CKD stage 3）, and group C（CKD stage 1～2） according to the rGFR, and the applicability of various equations in each group was compared. Results In the comparison of eGFR between the equations, the CKD-EPI<sub>diabetes</sub> equation had the smallest bias, with differences of statistical significance compared to Feng<sub>Cys C </sub>equation and Feng Scr-Cys C equation（P<0.05）; it had the highest precision, with differences of statistical significance compared to MDRD equation and CKD-EPI<sub>Cys C </sub>（P<0.05）. In the comparison of accuracy between the 7 equations,, the 10% accuracy and the 30% accuracy of the CKD-EPI<sub>diabetes</sub> equation were the highest, with differences of statistical significance compared to the simplified MDRD equation, CKD-EPI<sub>Scr</sub> equation and CKD-EPI<sub>Cys C</sub> equation（P<0.05）. Bland-Altman analysis showed that CKD-EPI<sub>diabetes</sub> equation had the best consistency limit. In group A, the difference between CKD-EPI<sub>Cys C</sub> equation eGFR and rGFR was not statistically significant, with the least bias, and highest 10% accuracy, 30% accuracy and 50% accuracy. Group B were similar to the overall groups, CKD-EPI<sub>diabetes</sub> equation had the least bias, the highest precision, 10% accuracy, 30% accuracy and 50% accuracy. Conclusions Among the 7 equations, the CKD-EPI<sub>diabetes</sub> equation has the best fit between eGFR and rGFR. In the grouped comparison, the CKD-EPI<sub>Cys C</sub> equation has the best fit in patients with CKD stage 4～5, CKD-EPI<sub>diabetes</sub> equation has the best fit in patients with CKD stage 3. The two equations can be used for estimation of GFR in different groups of patients with diabetes complicated with CKD.http://www.lcszb.com/thesisDetails?columnId=57910671&Fpath=home&index=0Glomerular filtration rate evaluation equationDiabetes mellitusChronic kidney diseaseDiabetic nephropathy |
| spellingShingle | LV Xiao-yang ZHONG Liang-bao WANG Shan-zhi ZHU Yong-jun LI xiao-yan Applicability evaluation of the GFR equations in Chinese patients with diabetes mellitus complicated with CKD Linchuang shenzangbing zazhi Glomerular filtration rate evaluation equation Diabetes mellitus Chronic kidney disease Diabetic nephropathy |
| title | Applicability evaluation of the GFR equations in Chinese patients with diabetes mellitus complicated with CKD |
| title_full | Applicability evaluation of the GFR equations in Chinese patients with diabetes mellitus complicated with CKD |
| title_fullStr | Applicability evaluation of the GFR equations in Chinese patients with diabetes mellitus complicated with CKD |
| title_full_unstemmed | Applicability evaluation of the GFR equations in Chinese patients with diabetes mellitus complicated with CKD |
| title_short | Applicability evaluation of the GFR equations in Chinese patients with diabetes mellitus complicated with CKD |
| title_sort | applicability evaluation of the gfr equations in chinese patients with diabetes mellitus complicated with ckd |
| topic | Glomerular filtration rate evaluation equation Diabetes mellitus Chronic kidney disease Diabetic nephropathy |
| url | http://www.lcszb.com/thesisDetails?columnId=57910671&Fpath=home&index=0 |
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