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Ann Lab Med. 2016 Nov;36(6):521-8. doi: 10.3343/alm.2016.36.6.521.

Comparing Results of Five Glomerular Filtration Rate-Estimating Equations in the Korean General Population: MDRD Study, Revised Lund-Malmö, and Three CKD-EPI Equations.

Author information

1
Department of Laboratory Medicine, Veterans Health Service Medical Center, Seoul, Korea.
2
Korea Association of Health Promotion, Seoul, Korea.
3
Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea. dearmina@hanmail.net.
4
Department of Cardiovascular Medicine, Konkuk University School of Medicine, Seoul, Korea.
5
Department of Medical Sciences and Translational Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.

Abstract

BACKGROUND:

Estimated glomerular filtration rate (eGFR) is a widely used index of kidney function. Recently, new formulas such as the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations or the Lund-Malmö equation were introduced for assessing eGFR. We compared them with the Modification of Diet in Renal Disease (MDRD) Study equation in the Korean adult population.

METHODS:

The study population comprised 1,482 individuals (median age 51 [42-59] yr, 48.9% males) who received annual physical check-ups during the year 2014. Serum creatinine (Cr) and cystatin C (CysC) were measured. We conducted a retrospective analysis using five GFR estimating equations (MDRD Study, revised Lund-Malmö, and Cr and/or CysC-based CKD-EPI equations). Reduced GFR was defined as eGFR <60 mL/min/1.73 m².

RESULTS:

For the GFR category distribution, large discrepancies were observed depending on the equation used; category G1 (≥90 mL/min/1.73 m²) ranged from 7.4-81.8%. Compared with the MDRD Study equation, the other four equations overestimated GFR, and CysC-based equations showed a greater difference (-31.3 for CKD-EPI(CysC) and -20.5 for CKD-EPI(Cr-CysC)). CysC-based equations decreased the prevalence of reduced GFR by one third (9.4% in the MDRD Study and 2.4% in CKD-EPI(CysC)).

CONCLUSIONS:

Our data shows that there are remarkable differences in eGFR assessment in the Korean population depending on the equation used, especially in normal or mildly decreased categories. Further prospective studies are necessary in various clinical settings.

KEYWORDS:

CKD-EPI equation; Estimated glomerular filtration rate; MDRD Study equation; Revised Lund-Malmö equation

PMID:
27578504
PMCID:
PMC5011104
DOI:
10.3343/alm.2016.36.6.521
[Indexed for MEDLINE]
Free PMC Article

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