Khandpur Sukhanshi, Awasthi Ashish, Behera Manas R, Purty Anil J, Singh Narinder P, Tiwari Swasti
Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India.
Centre for Chronic Disease Control, C1/52, 2(nd) Floor, Safdarjung Development Area, New Delhi 110016, India; Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurugram 122002, India.
Diabetes Res Clin Pract. 2022 Nov;193:110120. doi: 10.1016/j.diabres.2022.110120. Epub 2022 Oct 19.
CKD-EPI (chronic kidney disease-epidemiological) serum creatinine equation is widely accepted for calculating estimated glomerular filtration rate (eGFR). The effect of transitioning from the older 2009 to the newer race-independent 2021 CKD-EPI equation on the estimated kidney disease burden (eKDB) was studied in an Asian-Indian population.
The study included 1156 adults, the two equations were compared for agreement (Bland-Altman and Cohen's kappa) and concordance (Lin's correlation and test for proportions).
The 2021 CKD-EPI increased the eGFR (positive-bias), independent of age-group, gender or presence of type 2 diabetes mellitus (T2DM) and hypertension (HTN). Thus, the eKDB was significantly decreased by 2021 CKD-EPI equation. The agreement was highest for the age-group 31-40 years (95.8 % versus 87.5 % for > 50 years). Besides, the eGFR category was shifted from G3 to G1 in 8.2 % (95 % CI: 6.8-9.9) individuals by 2021 CKD-EPI. The effect of transition on eKDB was greater in individuals > 50 years (7.4 %) or with HTN (6.3 %).
In comparison to the old equation, the 2021 CKD-EPI equation increased the eGFR, lowering the eKDB in this Asian-Indian cohort. The degree of lowering was affected by age-group, and presence of T2DM /HTN, but independent of gender.
慢性肾脏病流行病学协作组(CKD-EPI)血清肌酐方程被广泛用于计算估计肾小球滤过率(eGFR)。本研究在亚洲印度人群中,探讨了从旧的2009年版到更新的种族无关的2021年版CKD-EPI方程对估计肾病负担(eKDB)的影响。
该研究纳入了1156名成年人,比较了两个方程的一致性(Bland-Altman法和Cohen's kappa系数)和协调性(Lin氏相关性和比例检验)。
2021年版CKD-EPI方程提高了eGFR(正向偏差),与年龄组、性别或2型糖尿病(T2DM)和高血压(HTN)的存在无关。因此,2021年版CKD-EPI方程使eKDB显著降低。31-40岁年龄组的一致性最高(95.8%,而>50岁年龄组为87.5%)。此外,2021年版CKD-EPI方程使8.2%(95%CI:6.8-9.9)的个体的eGFR类别从G3转变为G1。年龄>50岁(7.4%)或患有HTN(6.3%)的个体,方程转变对eKDB的影响更大。
与旧方程相比,2021年版CKD-EPI方程提高了eGFR,降低了该亚洲印度队列中的eKDB。降低程度受年龄组以及T2DM/HTN的存在影响,但与性别无关。