Comment to Assessment of the new CKD-EPI equation...
Comentario a Valoración de la nueva ecuación CDK-EPI...
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The first, due to its current nature; it has only been a few months since formulas to estimate glomerular filtration rate (eGFR) were published, based on CKD-EPI study (Chronic Kidney Disease Epidemiology Collaboration).<span class="elsevierStyleSup">2 </span>The second reason is that our group is working, albeit more modestly, along the same lines.  </p><p class="elsevierStylePara"> In our project “Knowing Diabetes Numbers” we collected measurements of fasting plasma glucose and HbA<span class="elsevierStyleSup">1c </span>(FPGHbA <span class="elsevierStyleSup">1c</span>) from September 2008 to February 2009 that were performed in the Department of Biochemistry of the Hospital of La Línea de la Concepción, where tests are carried out for the hospital and the six primary care centres (PC).  </p><p class="elsevierStylePara"> After excluding the 362 results that came from the outpatient nephrology clinic, 4,820 FPG-HbA<span class="elsevierStyleSup">1c </span>results were collected (from patients with a mean age of 64 ± 14 years), 55% were made in women and 74% came from PC. Of these, creatinine was also requested in 3,461 (72%), the albumin/creatinine ratio was requested in 1,397 (29%), and a specific request for eGFR was made in only 80 (less than 2%). Subsequently, we calculated the eGFR in the 1,953 requests in which data were available for age, sex, and creatinine using the classical MDRD formula (coefficient 186),<span class="elsevierStyleSup">3 </span>since the laboratory uses the modified kinetic Jaffé method (Beckman) without traceability to isotope dilution mass spectrometry (IDMS).<span class="elsevierStyleSup">4,5 </span> </p><p class="elsevierStylePara"> Our results in men were of CKD grade 3 in 13.2% and grades 1-2 in 1.6%. In women, 20% with grade 3 and 3.3% with grades 1-2. These data match the most recently reported data on prevalence of kidney disease in patients with diabetes.<span class="elsevierStyleSup">6 </span>By applying CKD-EPI, 1.2% of women and 2.5% of men had worsened grading (Table 1). If we apply the Bland-Altman graphic method, the results differ from those of Montañés et al.,<span class="elsevierStyleSup">1 </span>since there is an average discrepancy of 3.5ml/min (4.4%) favouring MDRD in men and 2.6ml/min (1.7%) favouring CKD-EPI in women (Figure 1). However, our concordance study (intraclass correlation coefficient and Lin coefficient) is greater than 98%.  </p><p class="elsevierStylePara"> These differences may be explained by the application of the classical formula (coefficient 186) rather than MDRD-IDMS (coefficient 175) and for the unequal population studied: PC versus the nephrology referral centre, 55% women vs. 30% and 81% with grades 4-5 vs. 63%.  </p><p class="elsevierStylePara"> However, on the other hand, the differences are so small that we can say that the new CKD-EPI formulas are tools that are as useful as MDRD and we hope that they will allow us to raise awareness and increase eGFR requests in primary care.  </p><p class="elsevierStylePara"><a href="grande/10259_18030_5941_en_table1.jpg" class="elsevierStyleCrossRefs"><img src="10259_18030_5941_en_table1.gif" alt="CKD grade classification by MDRD"></img></a></p><p class="elsevierStylePara">Table 1. CKD grade classification by MDRD</p><p class="elsevierStylePara"><a href="grande/10259_18030_5942_en_figure1.jpg" class="elsevierStyleCrossRefs"><img src="10259_18030_5942_en_figure1.jpg" alt="Bland Altman method for concordance between MDRD and CKD-EPI"></img></a></p><p class="elsevierStylePara">Figure 1. Bland Altman method for concordance between MDRD and CKD-EPI</p>" "pdfFichero" => "P1-E46-S1860-A10259-EN.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "tbl1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "10259_18030_5941_en_table1.jpg" "imagenAlto" => 288 "imagenAncho" => 519 "imagenTamanyo" => 107074 ] ] ] ] ] "descripcion" => array:1 [ "en" => "CKD grade classification by MDRD" ] ] 1 => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10259_18030_5942_en_figure1.jpg" "Alto" => 255 "Ancho" => 520 "Tamanyo" => 131533 ] ] "descripcion" => array:1 [ "en" => "Bland Altman method for concordance between MDRD and CKD-EPI" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "1.- \u{A0}Montañés R; Bover J; Oliver A; Ballarín JA; Gràcia S. Valoración de la \u{A0} nueva ecuación CKD-EPI para la estimación del filtrado glomerular.\u{A0}http://www.revistanefrologia.com/prepublicaciones" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "2.- \u{A0}Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al, CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A\u{A0}new equation to estimate glomerular filtration rate.\u{A0}Ann Intern Med\u{A0}2009; 150(9):604-12. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19414839" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "- Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum\u{A0}creatinine: a new prediction equation. Modification of Diet in Renal\u{A0}Disease Study Group. Ann Intern Med 1999; 130:461-70." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "- Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S,\u{A0}Kusek JW, Van Lente F; Chronic Kidney Disease Epidemiology\u{A0}Collaboration: Using standardized serum creatinine values in the\u{A0}modification of diet in renal disease study equation for estimating\u{A0}glomerular filtration rate. Ann Intern Med 2006; 145(4): 247-54 <a href="http://www.ncbi.nlm.nih.gov/pubmed/16908915" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "5.- Gracia S, Montañés R, Bover J, Cases A, Deulofeu R, Martín de Francisco\u{A0}L, et al. Documento de consenso: Recomendaciones sobre la utilización\u{A0}de ecuaciones para la estimación del filtrado glomerular en adultos. Nefrología 2006; 26(6):658-65. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17227242" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "6.- Rodríguez-Poncelas A, et al. Prevalencia de insuficiencia renal oculta y\u{A0}variables asociadas en una población de pacientes con diabetes tipo 2.\u{A0}MedClin (Barc) 2010.doi:10.1016/j.medcli.2009.06.069 (prepublicación)" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003000000003/v0_201502091603/X2013251410035741/v0_201502091604/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003000000003/v0_201502091603/X2013251410035741/v0_201502091604/en/P1-E46-S1860-A10259-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251410035741?idApp=UINPBA000064" ]
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| 2018 April | 58 | 11 | 69 |
| 2018 March | 57 | 12 | 69 |
| 2018 February | 54 | 9 | 63 |
| 2018 January | 61 | 6 | 67 |
| 2017 December | 49 | 7 | 56 |
| 2017 November | 30 | 5 | 35 |
| 2017 October | 37 | 5 | 42 |
| 2017 September | 29 | 15 | 44 |
| 2017 August | 29 | 6 | 35 |
| 2017 July | 33 | 9 | 42 |
| 2017 June | 26 | 6 | 32 |
| 2017 May | 34 | 10 | 44 |
| 2017 April | 25 | 12 | 37 |
| 2017 March | 20 | 6 | 26 |
| 2017 February | 19 | 3 | 22 |
| 2017 January | 21 | 7 | 28 |
| 2016 December | 60 | 7 | 67 |
| 2016 November | 65 | 7 | 72 |
| 2016 October | 88 | 15 | 103 |
| 2016 September | 89 | 4 | 93 |
| 2016 August | 135 | 5 | 140 |
| 2016 July | 123 | 5 | 128 |
| 2016 June | 110 | 0 | 110 |
| 2016 May | 135 | 0 | 135 |
| 2016 April | 93 | 0 | 93 |
| 2016 March | 89 | 0 | 89 |
| 2016 February | 100 | 0 | 100 |
| 2016 January | 98 | 0 | 98 |
| 2015 December | 80 | 0 | 80 |
| 2015 November | 72 | 0 | 72 |
| 2015 October | 63 | 0 | 63 |
| 2015 September | 70 | 0 | 70 |
| 2015 August | 64 | 0 | 64 |
| 2015 July | 67 | 0 | 67 |
| 2015 June | 21 | 0 | 21 |
| 2015 May | 49 | 0 | 49 |
| 2015 April | 7 | 0 | 7 |
Show all
