Risk implications of the new CKD Epidemiology Collaboration (CKD-EPI) equation compared with the MDRD Study equation for estimated GFR: the Atherosclerosis Risk in Communities (ARIC) Study.
Risk implications of the new CKD Epidemiology Collaboration (CKD-EPI) equation compared with the MDRD Study equation for estimated GFR: the Atherosclerosis Risk in Communities (ARIC) Study.
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DOI：
10.1053/j.ajkd.2009.12.016
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发表时间：
2010-04
期刊：
影响因子：
--
通讯作者：
Coresh J
中科院分区：
文献类型：
--
作者：
Matsushita K;Selvin E;Bash LD;Astor BC;Coresh J
慢性肾脏疾病流行病学合作（CKD-EPI）最近使用相同的变量（血清肌酐，年龄，性别和种族）作为肾脏疾病研究（MDRD）方程的饮食修饰（MDRD）方程的修饰，以估计的肾小球滤过率（EGFR）方程尽管与MDRD方程相比，CKD-EPI方程更精确地估计GFR，但该方程是否改善风险预测是未知的。
前瞻性队列研究，社区的动脉粥样硬化风险（ARIC）研究。
13,905名中年参与者没有心血管疾病史，中位随访时间为16。9年。
egfr
我们通过CKD-EPI和MDRD方程与EGFR类别（≥120、90-119、60–89、30-59、30 ml/min/1.73m2）的类别的关联与发生终末期肾脏疾病的风险（ESRD），全因死亡率，冠心病（CHD）和中风。
EGFRCKD-EPI的中值高于EGFRMDRD（97.6 vs. 88.8 ml/min/1.73m2，p <0.001）。 EGFRMDRD 60-89和30-59的参与者分别向更高的EGFR类别，但没有人使用EGFRMDRD 90-119或<30，从而降低了CKD阶段3-5的患病率从2.7％到2.7％到与未重新分类的人相比，重新分类的EGFRMDRD 30-59的参与者的风险较低（ESRD发病率比率为0.10 [95％CI，0.03-0.33] 0.48]，0.36 [0.21-0.61]，中风，0.24-1.01]年轻，女性和白人参与者在EGFR <120的参与者中解释了一些净重新分类。
EGFR <60的病例数量有限，没有蛋白尿的测量。
与MDRD方程相比，CKD-EPI方程在长期临床风险方面更为适当地分类，这表明该中年人群的临床实用性提高了。
The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) recently published an equation for estimated glomerular filtration rate (eGFR) using the same variables (serum creatinine, age, gender and race) as the Modification of Diet in Renal Disease Study (MDRD) equation. Although the CKD-EPI equation estimates GFR more precisely as compared with the MDRD equation, whether this equation improves risk prediction is unknown. Prospective cohort study, the Atherosclerosis Risk in Communities (ARIC) Study. 13,905 middle-aged participants without a history of cardiovascular disease with median follow-up of 16.9 years. eGFR We compared the association of eGFR in categories (≥120, 90–119, 60–89, 30–59, <30 ml/min/1.73m2) by the CKD-EPI and MDRD equations with risk of incident end-stage renal disease (ESRD), all-cause mortality, coronary heart disease (CHD), and stroke. Median of eGFRCKD-EPI was higher than that of eGFRMDRD (97.6 vs. 88.8 ml/min/1.73m2, P<0.001). The CKD-EPI equation reclassified 44.9% (n=3,079) and 43.5% (n=151) of participants with eGFRMDRD 60–89 and 30–59, respectively, upward to a higher eGFR category but no one with eGFRMDRD 90–119 or <30, lowering the prevalence of CKD stage 3–5 from 2.7% to 1.6%. Participants with eGFRMDRD 30–59 who were reclassified upward had lower risk as compared to those who were not reclassified (ESRD incidence rate ratio, 0.10 [95% CI, 0.03–0.33], all-cause mortality, 0.30 [0.19–0.48], CHD, 0.36 [0.21–0.61], stroke, 0.50 [0.24–1.01]). Similar results were observed for participants with eGFRMDRD 60–89. More frequent reclassification of younger, female, and white participants explained some of these trends. Net reclassification improvement among participants with eGFR <120 was positive for all outcomes (P<0.001). Limited number of cases with eGFR <60 and no measurement of albuminuria. The CKD-EPI equation more appropriately categorized individuals with respect to long-term clinical risk as compared to the MDRD equation, suggesting improved clinical usefulness in this middle-aged population.
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影响因子：
8.3
作者：
Rosamond, WD;Folsom, AR;Shahar, E
通讯作者：
Shahar, E
影响因子：
13.6
作者：
Kottgen, Anna;Russell, Stuart D.;Coresh, Josef
通讯作者：
Coresh, Josef
影响因子：
13.2
作者：
Stevens, Lesley A.;Coresh, Josef;Levey, Andrew S.
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影响因子：
39.2
作者：
Levey, Andrew S.;Coresh, Josef;Van Lente, Frederick
通讯作者：
Van Lente, Frederick
DOI：
10.1097/01.asn.0000091586.46532.b4
发表时间：
2003-11-01
影响因子：
13.6
作者：
Hsu, CY;Lin, F;Shlipak, MG
通讯作者：
Shlipak, MG