PMID- 36033773
OWN - NLM
STAT- MEDLINE
DCOM- 20220830
LR  - 20230123
IS  - 2296-2565 (Electronic)
IS  - 2296-2565 (Linking)
VI  - 10
DP  - 2022
TI  - The Chronic Kidney Disease Epidemiology Collaboration equations perform less well 
      in an older population with type 2 diabetes than their non-diabetic counterparts.
PG  - 952899
LID - 10.3389/fpubh.2022.952899 [doi]
LID - 952899
AB  - OBJECTIVES: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 
      equations are based on creatinine alone (CKD-EPIcr), cystatin C alone 
      (CKD-EPIcys) and combined creatinine and cystatin C (CKD-EPIcr-cys). It remains 
      unclear whether these equations perform differently in older adults with type 2 
      diabetes than they do in non-diabetic older individuals. METHODS: This 
      single-center cross-sectional study was performed in adults aged >/= 65 years 
      between January 2019 and December 2021. Glomerular filtration rate (GFR) was 
      measured by technetium-99m-diethylene triamine pentaacetic acid ((99m)Tc-DTPA) 
      renal dynamic imaging. The bias (difference between measured and estimated GFR), 
      precision [interquartile range (IQR) of the median difference between measured 
      GFR and estimated GFR] and accuracy P30 (percentage of estimated GFR within 30% 
      of measured GFR) were considered the criteria of equation performance. RESULTS: 
      Finally, 476 participants were enrolled, including 243 adults with type 2 
      diabetes and 233 non-diabetic adults. The mean age of the included participants 
      was 71.69 +/- 6.4 years and 262 (55%) were male. The mean measured GFR was 49.02 +/- 
      22.45 ml/min/1.73 m(2). The CKD-EPIcr-cys equation showed significantly greater 
      bias and lower accuracy (P30) in individuals with diabetes than in the 
      non-diabetic group (median bias, 4.08 vs. 0.41 ml/min/1.73 m(2), respectively, p 
      < 0.05; P30, 63.78% vs. 78.54%, respectively, p < 0.05). The precision IQR 
      indicated that CKD-EPIcr-cys had also lower precision in individuals with 
      diabetes than in the non-diabetic controls (17.27 vs. 15.49 ml/min/1.73 m(2), 
      respectively). Similar results were observed for CKD-EPIcr and CKD-EPIcys 
      equations. The P30 of all three equations failed to reach 80% in diabetic and 
      non-diabetic groups. CONCLUSIONS: The performance of the CKD-EPI equations was 
      lower in a group of patients aged >/= 65 years with type 2 diabetes than in 
      non-diabetic counterparts. However, each equation still had limitations regarding 
      accuracy in older adults with or without diabetes.
CI  - Copyright (c) 2022 Jiang, Zhang and Li.
FAU - Jiang, Shimin
AU  - Jiang S
AD  - Department of Nephrology, China-Japan Friendship Hospital, Beijing, China.
FAU - Zhang, Danyang
AU  - Zhang D
AD  - Graduate School of Peking Union Medical College, Peking Union Medical College and 
      Chinese Academy of Medical Sciences, Beijing, China.
FAU - Li, Wenge
AU  - Li W
AD  - Department of Nephrology, China-Japan Friendship Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220810
PL  - Switzerland
TA  - Front Public Health
JT  - Frontiers in public health
JID - 101616579
RN  - 0 (Cystatin C)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Aged
MH  - Creatinine
MH  - Cross-Sectional Studies
MH  - Cystatin C
MH  - *Diabetes Mellitus, Type 2
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Humans
MH  - Male
MH  - *Renal Insufficiency, Chronic
PMC - PMC9399614
OTO - NOTNLM
OT  - CKD-EPI equations
OT  - creatinine
OT  - cystatin C
OT  - elderly
OT  - glomerular filtration rate
OT  - type 2 diabetes
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/08/30 06:00
MHDA- 2022/08/31 06:00
PMCR- 2022/08/10
CRDT- 2022/08/29 04:58
PHST- 2022/05/25 00:00 [received]
PHST- 2022/07/19 00:00 [accepted]
PHST- 2022/08/29 04:58 [entrez]
PHST- 2022/08/30 06:00 [pubmed]
PHST- 2022/08/31 06:00 [medline]
PHST- 2022/08/10 00:00 [pmc-release]
AID - 10.3389/fpubh.2022.952899 [doi]
PST - epublish
SO  - Front Public Health. 2022 Aug 10;10:952899. doi: 10.3389/fpubh.2022.952899. 
      eCollection 2022.