Comparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study

Mengjing Wang,1,2,* Xuehui Sun,3,* Li Ni,1 Minmin Zhang,1 Jiaying Zhang,4 Guoxin Ye,1 Li Jin,2,3 Xiaofeng Wang,2,3 Jing Chen1,2 1Nephrology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 2National Clinical Research Center for Aging and Medicine, Huashan Hospital...

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Autores principales:	Wang M, Sun X, Ni L, Zhang M, Zhang J, Ye G, Jin L, Wang X, Chen J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	glomerular filtration rate kidney function equation exceptional longevity mortality. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/00e1ebfbd57a4465988cbee3b6b60e3c
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spelling	oai:doaj.org-article:00e1ebfbd57a4465988cbee3b6b60e3c2021-12-02T12:08:44ZComparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study1178-1998https://doaj.org/article/00e1ebfbd57a4465988cbee3b6b60e3c2020-05-01T00:00:00Zhttps://www.dovepress.com/comparative-performance-of-creatinine-based-gfr-estimation-equations-i-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Mengjing Wang,1,2,* Xuehui Sun,3,* Li Ni,1 Minmin Zhang,1 Jiaying Zhang,4 Guoxin Ye,1 Li Jin,2,3 Xiaofeng Wang,2,3 Jing Chen1,2 1Nephrology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 2National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 3State Key Laboratory of Genetic Engineering and Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, People’s Republic of China; 4Nutrition, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jing Chen; Xiaofeng Wang Email chenjing1998@fudan.edu.cn; xiaofengwang71@163.comPurpose: Reduced kidney function has been associated with an increased risk for adverse outcomes. Accurate assessment of glomerular filtration rate (GFR) is key to diagnosis and management of kidney disfunction. Debate exists on the best GFR estimation equation for elderly people. This study aimed to compare the predictive validity and discriminative ability of four GFR equations in relation to 2-year and 6-year mortality in exceptional longevity (EL) (those over 95 years old with intact health) individuals and is an ideal model to address factors relating to life span and age-related diseases.Patients and Methods: This study used 6 years’ data of 278 EL from the Rugao longevity cohort. Baseline GFR was estimated using four equations: Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, Modification of Diet in Renal Disease Study (MDRD) equation, Berlin Initiative Study-1 (BIS) equation, and modified MDRD equation. Predictive validity was tested using Cox proportional hazards analysis. Overall improvement in reclassification based on estimated GFR (eGFR) was assessed applying net reclassification improvement (NRI).Results: Mean age of participants was 97± 2 years with median follow-up of 2.6 years. Median (IQR) eGFR by CKD-EPI, MDRD, BIS, and modified MDRD equations were 73.9 (62.2– 77.6), 82.3 (67.4– 98.6), 56.4 (47.9– 63.9), and 101.5 (83.1– 121.6) mL/min per 1.73 m2, respectively. Higher eGFREPI was associated with lower mortality after multivariate adjustment (for continuous eGFREPI, HRtwo-year 1.018, 95% CI 1.002– 1.033, P=0.023; HRsix-year 1.013, 95% CI 1.002– 1.025, P=0.022), while eGFR from other equations did not show any associations with mortality. NRI for two-year mortality was 0.14 and approximately significant, which may favor the CKD-EPI when compared to BIS equation (P=0.052).Conclusion: The CKD-EPI equation showed more accurate estimation of kidney function in the elderly with respect to GFR distribution and predictability of mortality risk.Keywords: glomerular filtration rate, kidney function, equation, exceptional longevity, mortalityWang MSun XNi LZhang MZhang JYe GJin LWang XChen JDove Medical Pressarticleglomerular filtration ratekidney functionequationexceptional longevitymortality.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 733-742 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	glomerular filtration rate kidney function equation exceptional longevity mortality. Geriatrics RC952-954.6
spellingShingle	glomerular filtration rate kidney function equation exceptional longevity mortality. Geriatrics RC952-954.6 Wang M Sun X Ni L Zhang M Zhang J Ye G Jin L Wang X Chen J Comparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study
description	Mengjing Wang,1,2,* Xuehui Sun,3,* Li Ni,1 Minmin Zhang,1 Jiaying Zhang,4 Guoxin Ye,1 Li Jin,2,3 Xiaofeng Wang,2,3 Jing Chen1,2 1Nephrology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 2National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 3State Key Laboratory of Genetic Engineering and Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, People’s Republic of China; 4Nutrition, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jing Chen; Xiaofeng Wang Email chenjing1998@fudan.edu.cn; xiaofengwang71@163.comPurpose: Reduced kidney function has been associated with an increased risk for adverse outcomes. Accurate assessment of glomerular filtration rate (GFR) is key to diagnosis and management of kidney disfunction. Debate exists on the best GFR estimation equation for elderly people. This study aimed to compare the predictive validity and discriminative ability of four GFR equations in relation to 2-year and 6-year mortality in exceptional longevity (EL) (those over 95 years old with intact health) individuals and is an ideal model to address factors relating to life span and age-related diseases.Patients and Methods: This study used 6 years’ data of 278 EL from the Rugao longevity cohort. Baseline GFR was estimated using four equations: Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, Modification of Diet in Renal Disease Study (MDRD) equation, Berlin Initiative Study-1 (BIS) equation, and modified MDRD equation. Predictive validity was tested using Cox proportional hazards analysis. Overall improvement in reclassification based on estimated GFR (eGFR) was assessed applying net reclassification improvement (NRI).Results: Mean age of participants was 97± 2 years with median follow-up of 2.6 years. Median (IQR) eGFR by CKD-EPI, MDRD, BIS, and modified MDRD equations were 73.9 (62.2– 77.6), 82.3 (67.4– 98.6), 56.4 (47.9– 63.9), and 101.5 (83.1– 121.6) mL/min per 1.73 m2, respectively. Higher eGFREPI was associated with lower mortality after multivariate adjustment (for continuous eGFREPI, HRtwo-year 1.018, 95% CI 1.002– 1.033, P=0.023; HRsix-year 1.013, 95% CI 1.002– 1.025, P=0.022), while eGFR from other equations did not show any associations with mortality. NRI for two-year mortality was 0.14 and approximately significant, which may favor the CKD-EPI when compared to BIS equation (P=0.052).Conclusion: The CKD-EPI equation showed more accurate estimation of kidney function in the elderly with respect to GFR distribution and predictability of mortality risk.Keywords: glomerular filtration rate, kidney function, equation, exceptional longevity, mortality
format	article
author	Wang M Sun X Ni L Zhang M Zhang J Ye G Jin L Wang X Chen J
author_facet	Wang M Sun X Ni L Zhang M Zhang J Ye G Jin L Wang X Chen J
author_sort	Wang M
title	Comparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study
title_short	Comparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study
title_full	Comparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study
title_fullStr	Comparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study
title_full_unstemmed	Comparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study
title_sort	comparative performance of creatinine-based gfr estimation equations in exceptional longevity: the rugao longevity and ageing study
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/00e1ebfbd57a4465988cbee3b6b60e3c
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Comparative Performance of Creatinine-Based GFR Estimation Equations in Exceptional Longevity: The Rugao Longevity and Ageing Study

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