Impact of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) GFR Estimating Equations on CKD Prevalence and Classification Among Asians

BackgroundIn 2021, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) validated a new equation for estimated glomerular filtration rate (eGFR). However, this new equation is not ethnic-specific, and prevalence of CKD in Asians is known to differ from other ethnicities. This study evalua...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:Frontiers in medicine Ročník 9; s. 957437
Hlavní autoři: Betzler, Bjorn Kaijun, Sultana, Rehena, He, Feng, Tham, Yih Chung, Lim, Cynthia Ciwei, Wang, Ya Xing, Nangia, Vinay, Tai, E. Shyong, Rim, Tyler Hyungtaek, Bikbov, Mukharram M., Jonas, Jost B., Kang, Se Woong, Park, Kyu Hyung, Cheng, Ching-Yu, Sabanayagam, Charumathi
Médium: Journal Article
Jazyk:angličtina
Vydáno: Lausanne Frontiers Media SA 14.07.2022
Frontiers Media S.A
Témata:
Age
Asian
Asian people
Blood pressure
Body mass index
chronic kidney disease
Collaboration
Creatinine
Diabetes
Epidemiology
Ethnicity
glomerular filtration rate
Hypertension
Kidney diseases
Medical referrals
Medicine
Minority & ethnic groups
Population-based studies
prevalence
Risk factors
United States > US
Singapore
India
ISSN:2296-858X, 2296-858X
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Popis
Shrnutí:BackgroundIn 2021, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) validated a new equation for estimated glomerular filtration rate (eGFR). However, this new equation is not ethnic-specific, and prevalence of CKD in Asians is known to differ from other ethnicities. This study evaluates the impact of the 2009 and 2021 creatinine-based eGFR equations on the prevalence of CKD in multiple Asian cohorts.MethodsEight population-based studies from China, India, Russia (Asian), Singapore and South Korea provided individual-level data ( n = 67,233). GFR was estimated using both the 2009 CKD-EPI equation developed using creatinine, age, sex, and race (eGFRcr [2009, ASR]) and the 2021 CKD-EPI equation developed without race (eGFRcr [2021, AS]). CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 (G3-G5). Prevalence of eGFR categories was compared within each study and within subgroups of age, sex, body mass index (BMI), diabetes, and hypertension status. The extent of reclassification was examined using net reclassification improvement (NRI).FindingsOf 67,233 adults, CKD prevalence was 8.6% ( n = 5800/67,233) using eGFRcr (2009, ASR) and 6.4% ( n = 4307/67,233) using eGFRcr (2021, AS). With the latter, CKD prevalence was reduced across all eight studies, ranging from −7.0% (95% CI −8.5% to −5.4%) to −0.4% (−1.3% to 0.5%), and across all subgroups except those in the BMI < 18.5% subgroup. Net reclassification index (NRI) was significant at −2.33% ( p < 0.001). No individuals were reclassified as a higher (more severe) eGFR category, while 1.7%−4.2% of individuals with CKD were reclassified as one eGFR category lower when eGFRcr (2021, AS) rather than eGFRcr (2009, ASR) was used.InterpretationeGFRcr (2021, AS) consistently provided reduced CKD prevalence and higher estimation of GFR among Asian cohorts than eGFRcr (2009, ASR). Based on current risk-stratified approaches to CKD management, more patients reclassified to lower-risk GFR categories could help reduce inappropriate care and its associated adverse effects among Asian renal patients. Comparison of both equations to predict progression to renal failure or adverse outcomes using prospective studies are warranted.FundingNational Medical Research Council, Singapore.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
This article was submitted to Nephrology, a section of the journal Frontiers in Medicine
Edited by: Kook-Hwan Oh, Seoul National University, South Korea
Reviewed by: Ji Hye Kim, Seoul National University Hospital, Seoul, South Korea; Wei Liu, Guangdong Provincial People's Hospital, China
ISSN:2296-858X
2296-858X
DOI:10.3389/fmed.2022.957437