Evaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus

Mei Guo,1 Jian-Ying Niu,2 Xian-Wu Ye,2 Xiao-Jie Han,2 Ying Zha,2 Yang Hong,2 Hong Fang,3 Yong Gu2,4 1Zhongshan-Xuhui Hospital, Affiliated with Fudan University, 2The Fifth People’s Hospital of Shanghai, Fudan University, 3Shanghai Minhang Center for Disease Control and Prevention, 4Depart...

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Autores principales:	Guo M, Niu JY, Ye XW, Han XJ, Zha Y, Hong Y, Fang H, Gu Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	creatinine-based equations renal function elderly Chinese patients type 2 diabetes mellitus electronic health records Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/be1534263773478a8dabcf12e3cd6723
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spelling	oai:doaj.org-article:be1534263773478a8dabcf12e3cd67232021-12-02T06:18:51ZEvaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus1178-1998https://doaj.org/article/be1534263773478a8dabcf12e3cd67232017-10-01T00:00:00Zhttps://www.dovepress.com/evaluation-of-various-equations-for-estimating-renal-function-in-elder-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Mei Guo,1 Jian-Ying Niu,2 Xian-Wu Ye,2 Xiao-Jie Han,2 Ying Zha,2 Yang Hong,2 Hong Fang,3 Yong Gu2,4 1Zhongshan-Xuhui Hospital, Affiliated with Fudan University, 2The Fifth People’s Hospital of Shanghai, Fudan University, 3Shanghai Minhang Center for Disease Control and Prevention, 4Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China Background: The clinical assessment of kidney function based on the estimated glomerular filtration rate (GFR) in older patients remains controversial. This study evaluated the concordance and feasibility of using various creatinine-based equations for estimating GFR in elderly Chinese patients with type 2 diabetes mellitus (T2DM).Methods: A cross-sectional analytical study was conducted in 21,723 older diabetic patients (≥60 years) based on electronic health records (EHR) for Minhang District, Shanghai, China. The concordance of chronic kidney disease (CKD) classification among different creatinine-based equations was assessed based on Kappa values, intraclass correlation coefficient (ICC) statistics, and the eGFR agreement between the equations was tested using Bland–Altman plots. The GFR was estimated using the Cockcroft–Gault (CG), Berlin Initiative Study 1 (BIS1), simplified Modification of Diet in Renal Disease (MDRD), MDRD modified for Chinese populations (mMDRD), chronic kidney disease epidemiology collaboration (CKD-EPI), CKD-EPI in Asians (CKD-EPI-Asia), and Ruijin equations.Results: Overall, the proportion of CKD stages 3–5 (eGFR <60 mL/min/1.73 m2) was calculated as 28.9%, 39.1%, 11.8%, 8.4%, 14.3%, 11.5%, and 12.7% by the eGFRCG, eGFRBIS1, eGFRMDRD, eGFRmMDRD, eGFRCKD-EPI, eGFRCKD-EPI-Asia, and eGFRRuijin equations, respectively. The concordance of albuminuria and decreased eGFR based on the different equations was poor by both the Kappa (<0.2) and ICC (<0.4) statistics. The CKD-EPI-Asia equation resulted in excellent concordance with the CKD-EPI (ICC =0.931), MDRD (ICC =0.963), mMDRD (ICC =0.892), and Ruijin (ICC =0.956) equations for the classification of CKD stages, whereas the BIS1 equation exhibited good concordance with the CG equation (ICC =0.809). In addition, significant differences were observed for CKD stage 1 among all these equations.Conclusion: Accurate GFR values are difficult to estimate using creatinine-based equations in older diabetic patients. Kidney function is complex, and the staff need to be aware of the individualized consideration of other risk factors or markers of reduced renal function in clinical practice. Keywords: estimated glomerular filtration rate, renal function, elderly, type 2 diabetes mellitus, electronic health records Guo MNiu JYYe XWHan XJZha YHong YFang HGu YDove Medical Pressarticlecreatinine-based equationsrenal functionelderly Chinese patientstype 2 diabetes mellituselectronic health recordsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1661-1672 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	creatinine-based equations renal function elderly Chinese patients type 2 diabetes mellitus electronic health records Geriatrics RC952-954.6
spellingShingle	creatinine-based equations renal function elderly Chinese patients type 2 diabetes mellitus electronic health records Geriatrics RC952-954.6 Guo M Niu JY Ye XW Han XJ Zha Y Hong Y Fang H Gu Y Evaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus
description	Mei Guo,1 Jian-Ying Niu,2 Xian-Wu Ye,2 Xiao-Jie Han,2 Ying Zha,2 Yang Hong,2 Hong Fang,3 Yong Gu2,4 1Zhongshan-Xuhui Hospital, Affiliated with Fudan University, 2The Fifth People’s Hospital of Shanghai, Fudan University, 3Shanghai Minhang Center for Disease Control and Prevention, 4Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China Background: The clinical assessment of kidney function based on the estimated glomerular filtration rate (GFR) in older patients remains controversial. This study evaluated the concordance and feasibility of using various creatinine-based equations for estimating GFR in elderly Chinese patients with type 2 diabetes mellitus (T2DM).Methods: A cross-sectional analytical study was conducted in 21,723 older diabetic patients (≥60 years) based on electronic health records (EHR) for Minhang District, Shanghai, China. The concordance of chronic kidney disease (CKD) classification among different creatinine-based equations was assessed based on Kappa values, intraclass correlation coefficient (ICC) statistics, and the eGFR agreement between the equations was tested using Bland–Altman plots. The GFR was estimated using the Cockcroft–Gault (CG), Berlin Initiative Study 1 (BIS1), simplified Modification of Diet in Renal Disease (MDRD), MDRD modified for Chinese populations (mMDRD), chronic kidney disease epidemiology collaboration (CKD-EPI), CKD-EPI in Asians (CKD-EPI-Asia), and Ruijin equations.Results: Overall, the proportion of CKD stages 3–5 (eGFR <60 mL/min/1.73 m2) was calculated as 28.9%, 39.1%, 11.8%, 8.4%, 14.3%, 11.5%, and 12.7% by the eGFRCG, eGFRBIS1, eGFRMDRD, eGFRmMDRD, eGFRCKD-EPI, eGFRCKD-EPI-Asia, and eGFRRuijin equations, respectively. The concordance of albuminuria and decreased eGFR based on the different equations was poor by both the Kappa (<0.2) and ICC (<0.4) statistics. The CKD-EPI-Asia equation resulted in excellent concordance with the CKD-EPI (ICC =0.931), MDRD (ICC =0.963), mMDRD (ICC =0.892), and Ruijin (ICC =0.956) equations for the classification of CKD stages, whereas the BIS1 equation exhibited good concordance with the CG equation (ICC =0.809). In addition, significant differences were observed for CKD stage 1 among all these equations.Conclusion: Accurate GFR values are difficult to estimate using creatinine-based equations in older diabetic patients. Kidney function is complex, and the staff need to be aware of the individualized consideration of other risk factors or markers of reduced renal function in clinical practice. Keywords: estimated glomerular filtration rate, renal function, elderly, type 2 diabetes mellitus, electronic health records
format	article
author	Guo M Niu JY Ye XW Han XJ Zha Y Hong Y Fang H Gu Y
author_facet	Guo M Niu JY Ye XW Han XJ Zha Y Hong Y Fang H Gu Y
author_sort	Guo M
title	Evaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus
title_short	Evaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus
title_full	Evaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus
title_fullStr	Evaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus
title_full_unstemmed	Evaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus
title_sort	evaluation of various equations for estimating renal function in elderly chinese patients with type 2 diabetes mellitus
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/be1534263773478a8dabcf12e3cd6723
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Evaluation of various equations for estimating renal function in elderly Chinese patients with type 2 diabetes mellitus

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