PMID- 29070944
OWN - NLM
STAT- MEDLINE
DCOM- 20180417
LR  - 20181202
IS  - 1178-1998 (Electronic)
IS  - 1176-9092 (Print)
IS  - 1176-9092 (Linking)
VI  - 12
DP  - 2017
TI  - Evaluation of various equations for estimating renal function in elderly Chinese 
      patients with type 2 diabetes mellitus.
PG  - 1661-1672
LID - 10.2147/CIA.S140289 [doi]
AB  - BACKGROUND: The clinical assessment of kidney function based on the estimated 
      glomerular filtration rate (GFR) in older patients remains controversial. This 
      study evaluated the concordance and feasibility of using various creatinine-based 
      equations for estimating GFR in elderly Chinese patients with type 2 diabetes 
      mellitus (T2DM). METHODS: A cross-sectional analytical study was conducted in 
      21,723 older diabetic patients (>/=60 years) based on electronic health records 
      (EHR) for Minhang District, Shanghai, China. The concordance of chronic kidney 
      disease (CKD) classification among different creatinine-based equations was 
      assessed based on Kappa values, intraclass correlation coefficient (ICC) 
      statistics, and the eGFR agreement between the equations was tested using 
      Bland-Altman plots. The GFR was estimated using the Cockcroft-Gault (CG), Berlin 
      Initiative Study 1 (BIS1), simplified Modification of Diet in Renal Disease 
      (MDRD), MDRD modified for Chinese populations (mMDRD), chronic kidney disease 
      epidemiology collaboration (CKD-EPI), CKD-EPI in Asians (CKD-EPI-Asia), and 
      Ruijin equations. RESULTS: Overall, the proportion of CKD stages 3-5 (eGFR <60 
      mL/min/1.73 m(2)) was calculated as 28.9%, 39.1%, 11.8%, 8.4%, 14.3%, 11.5%, and 
      12.7% by the eGFR(CG), eGFR(BIS1), eGFR(MDRD), e(GFRmMDRD), e(GFRCKD-EPI), 
      e(GFRCKD-EPI-Asia), and e(GFRRuijin) equations, respectively. The concordance of 
      albuminuria and decreased eGFR based on the different equations was poor by both 
      the Kappa (<0.2) and ICC (<0.4) statistics. The CKD-EPI-Asia equation resulted in 
      excellent concordance with the CKD-EPI (ICC =0.931), MDRD (ICC =0.963), mMDRD 
      (ICC =0.892), and Ruijin (ICC =0.956) equations for the classification of CKD 
      stages, whereas the BIS1 equation exhibited good concordance with the CG equation 
      (ICC =0.809). In addition, significant differences were observed for CKD stage 1 
      among all these equations. CONCLUSION: Accurate GFR values are difficult to 
      estimate using creatinine-based equations in older diabetic patients. Kidney 
      function is complex, and the staff need to be aware of the individualized 
      consideration of other risk factors or markers of reduced renal function in 
      clinical practice.
FAU - Guo, Mei
AU  - Guo M
AD  - Zhongshan-Xuhui Hospital, Affiliated with Fudan University.
FAU - Niu, Jian-Ying
AU  - Niu JY
AD  - The Fifth People's Hospital of Shanghai, Fudan University.
FAU - Ye, Xian-Wu
AU  - Ye XW
AD  - The Fifth People's Hospital of Shanghai, Fudan University.
FAU - Han, Xiao-Jie
AU  - Han XJ
AD  - The Fifth People's Hospital of Shanghai, Fudan University.
FAU - Zha, Ying
AU  - Zha Y
AD  - The Fifth People's Hospital of Shanghai, Fudan University.
FAU - Hong, Yang
AU  - Hong Y
AD  - The Fifth People's Hospital of Shanghai, Fudan University.
FAU - Fang, Hong
AU  - Fang H
AD  - Shanghai Minhang Center for Disease Control and Prevention.
FAU - Gu, Yong
AU  - Gu Y
AD  - The Fifth People's Hospital of Shanghai, Fudan University.
AD  - Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
LA  - eng
PT  - Journal Article
DEP - 20171009
PL  - New Zealand
TA  - Clin Interv Aging
JT  - Clinical interventions in aging
JID - 101273480
RN  - 0 (Biomarkers)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Aged
MH  - Biomarkers/analysis
MH  - China/epidemiology
MH  - Creatinine/analysis
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Renal Insufficiency/epidemiology/physiopathology
MH  - Renal Insufficiency, Chronic/*epidemiology/*physiopathology
MH  - Risk Factors
PMC - PMC5640414
OTO - NOTNLM
OT  - elderly
OT  - electronic health records
OT  - estimated glomerular filtration rate
OT  - renal function
OT  - type 2 diabetes mellitus
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2017/10/27 06:00
MHDA- 2018/04/18 06:00
PMCR- 2017/10/09
CRDT- 2017/10/27 06:00
PHST- 2017/10/27 06:00 [entrez]
PHST- 2017/10/27 06:00 [pubmed]
PHST- 2018/04/18 06:00 [medline]
PHST- 2017/10/09 00:00 [pmc-release]
AID - cia-12-1661 [pii]
AID - 10.2147/CIA.S140289 [doi]
PST - epublish
SO  - Clin Interv Aging. 2017 Oct 9;12:1661-1672. doi: 10.2147/CIA.S140289. eCollection 
      2017.