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Clinical Implications of Estimating Glomerular Filtration Rate with Three Different Equations Among Older People. Preliminary Results of the Project "Screening for Chronic Kidney Disease among Older People across Europe (SCOPE)".
Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala University / Karolinska Institutet.ORCID iD: 0000-0002-6933-4637
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2020 (English)In: Journal of clinical medicine, ISSN 2077-0383, Vol. 9, no 2, article id E294Article in journal (Refereed) Published
Abstract [en]

We aimed at investigating to what extent CKD may be staged interchangeably by three different eGFR equations in older people, and evaluating the source of discrepancies among equations in a population of 2257 patients older than 75 years enrolled in a multicenter observational study. eGFR was calculated by CKD-EPI, BIS and FAS equations. Statistical analysis was carried out by Bland-Altman analysis. κ statistic was used to quantify the agreement between equations in classifying CKD stages. The impact of selected variables on the difference among equations was graphically explored. The average difference between BIS and FAS was -0.24 (95% limits of agreement (95%LA = -4.64-4.14) mL/min/1.73 m2. The difference between CKD-EPI and BIS and between CKD-EPI and FAS was 8.97 (95%LA = -2.90-20.84) and 8.72 (95%LA = -2.11-19.56) mL/min/1.73 m2, respectively. As regards CKD stage classification, κ value was 0.47 for both CKD-EPI vs. FAS and CKD-EPI vs. BIS, while BIS and FAS had similar classificatory properties (κ = 0.90). Muscle mass was found related to the difference between CKD-EPI and BIS (R2 = 0.11) or FAS (R2 = 0.14), but not to the difference between BIS and FAS. In conclusion, CKD-EPI and BIS/FAS equations are not interchangeable to assess eGFR among older people. Muscle mass may represent a relevant source of discrepancy among eGFR equations.

Place, publisher, year, edition, pages
2020. Vol. 9, no 2, article id E294
Keywords [en]
Berlin Initiative Study (BIS), Full Age Spectrum (FAS), chronic kidney disease (CKD), estimated glomerular filtration rate (eGFR), muscle mass, older patients, sarcopenia, sex
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-31735DOI: 10.3390/jcm9020294ISI: 000518823000007PubMedID: 31973029OAI: oai:DiVA.org:du-31735DiVA, id: diva2:1389306
Available from: 2020-01-29 Created: 2020-01-29 Last updated: 2020-03-26

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Ärnlöv, Johan

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