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Am J Kidney Dis. 2010 Jul;56(1):32-8. doi: 10.1053/j.ajkd.2010.02.344. Epub 2010 Apr 22.

Modification of the CKD epidemiology collaboration (CKD-EPI) equation for Japanese: accuracy and use for population estimates.

Author information

1
Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan.

Abstract

INTRODUCTION:

We previously reported a modification to the Modification of Diet in Renal Disease (MDRD) Study equation for use in Japan. Recently, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) developed a new equation that is more accurate and yields a lower CKD prevalence estimate in the United States than the MDRD Study equation. We modified the CKD-EPI equation for use in Japan, compared its accuracy with the Japanese modification of the MDRD Study equation, and compared the prevalence of CKD in Japan using both equations.

DESIGN:

A diagnostic test study comparing the Japanese coefficient-modified CKD-EPI equation and Japanese coefficient-modified MDRD Study equation and a cross-sectional study comparing distribution of estimated glomerular filtration rate and prevalence of CKD in participants in a Japanese annual health check program.

SETTING & PARTICIPANTS:

763 Japanese patients (413 for development and 350 for validation) were included. Prevalence estimates were based on 574,024 participants from the annual health check program.

INDEX TEST:

Japanese modification of the MDRD Study and CKD-EPI equations.

REFERENCE TEST:

Inulin clearance.

RESULTS:

The Japanese coefficient of the modified CKD-EPI equation was 0.813 (95% CI, 0.794-0.833). In the validation data set, the modified CKD-EPI equation performed better than the modified MDRD Study equation. Bias (measured GFR [mGFR] - eGFR) was 0.4 +/- 17.8 (SD) versus 1.3 +/- 19.8 mL/min/1.73 m(2) overall, respectively (P = 0.02); 7.3 +/- 20.6 versus 7.8 +/- 22.2 mL/min/1.73 m(2) for participants with mGFR >or=60 mL/min/1.73 m(2), respectively (P < 0.001); and -4.4 +/- 13.8 versus -3.3 +/- 15.6 mL/min/1.73 m(2) for participants with mGFR <60 mL/min/1.73 m(2), respectively (P = 0.5). The modified CKD-EPI equation yields a lower estimated prevalence of CKD than the modified MDRD Study equation (7.9% vs 10.0%), primarily because of a lower estimated prevalence of stage 3 (5.2% vs 7.5%).

LIMITATION:

Most study participants had CKD. The study population contained a limited number of participants with mGFR >or=90 mL/min/1.73 m(2).

CONCLUSION:

The Japanese coefficient-modified CKD-EPI equation is more accurate than the Japanese coefficient-modified MDRD Study equation and leads to a lower estimated prevalence of CKD in Japan.

PMID:
20416999
DOI:
10.1053/j.ajkd.2010.02.344
[Indexed for MEDLINE]
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