The performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD- EPI) and Modification of Diet in Renal Disease (MDRD) formulas for estimating Glomerular Filtration Rate (eGFR) in Indigenous Australians with and without diabetes — ASN Events
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  3. The performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD- EPI) and Modification of Diet in Renal Disease (MDRD) formulas for estimating Glomerular Filtration Rate (eGFR) in Indigenous Australians with and without diabetes

The performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD- EPI) and Modification of Diet in Renal Disease (MDRD) formulas for estimating Glomerular Filtration Rate (eGFR) in Indigenous Australians with and without diabetes (#16)

Louise J Maple-Brown 1 2 , Elif I Ekinci 1 3 4 , Jaquelyne T Hughes 1 2 , Paul D Lawton 1 , Graham RD Jones 5 6 , Andrew G Ellis 3 4 , Alan Cass 7 8 , Wendy E Hoy 9 , Kerin O'Dea 10 , George Jerums 3 4 , Richard J MacIsaac 4 11
  1. Menzies School of Health Research, Darwin, Northern Territory, Australia
  2. Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
  3. Austin Health, Heidelberg West, VIC, Australia
  4. Department of Medicine Austin Health, University of Melbourne, Melbourne, VIC, Australia
  5. SydPath, St Vincents Hospital, Sydney, NSW, Australia
  6. University of NSW, Sydney, NSW, Australia
  7. The George Institute for Global Health, Sydney, NSW, Australia
  8. University of Sydney, Sydney, Australia
  9. University of Queensland, Brisbane, Queensland, Australia
  10. University of South Australia, Adelaide, South Australia, Australia
  11. Department of Endocrinology and Diabetes, St Vincents Hospital, Melbourne, Melbourne, Victoria, Australia

Background:  The CKD-EPI formula has been proposed as a more accurate marker of GFR than the MDRD formula. However, the best method for estimating GFR in Indigenous Australians with diabetes is still unclear.

Aims:  To analyse the performance of CKD-EPI and MDRD formulas for estimating GFR (eGFR) in Indigenous Australians with or without diabetes.

Methods:  Participants were Indigenous Australians with (n= 234) or without (n=345) type 2 diabetes (T2DM).  A reference GFR measurement was obtained using the plasma disappearance of iohexol (mGFR) over 4 hours.  Serum creatinine was measured by an enzymatic method.  Performance was determined as bias (absolute difference), derived from mGFR-eGFR and accuracy (percentage of eGFR within 30% of mean mGFR).

Results:  In the entire study population, the performance of the CKD-EPI formula was superior to the MDRD formula. However, in Indigenous Australians with diabetes, the CKD-EPI formula underestimated mGFR to a greater extent (p < 0.05) and was less accurate (p < 0.05) than in those without diabetes (Table).

351-Elif%20table.jpg

Conclusion: In Indigenous Australians with diabetes, the CKD-EPI formula has a greater negative bias and is less accurate compared to those without diabetes. Nevertheless, the CKD-EPI equation outperforms the MDRD equation in all Indigenous Australians and remains the preferred equation to estimate GFR in this high risk population.