Aim: The aim was to investigate to what extent chronic kidney disease (CKD) can be staged interchangeably by Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and by Berlin Initiative Study (BIS) equations, and to verify whether cystatin C can improve concordance between formulas. Methods: Our series consisted of 828 community-dwelling individuals aged 65 years or older enrolled in the Invecchiare in Chianti Study (“Aging in the Chianti Region”). Estimated glomerular filtration rate was calculated using the creatinine-based CKD-EPI, creatinine/cystatin C-based CKD-EPI, creatinine-based BIS and creatinine/cystatin C-based BIS equations. Agreement and sources of discrepancy between equations in identifying people with different degrees of kidney dysfunction was investigated by κ statistic and Bland–Altman plots. Results: Overall, CKD-EPI values were higher than that obtained with BIS equations, especially for eGFR = 30–60 mL/min/1.73 m2. A total of 191 out of 828 participants were classified in stage 2 by the creatinine-based CKD-EPI and in stage 3a by the creatinine-based BIS equation, whereas 123 participants were classified in stage 2 by creatinine/cystatin C-based CKD-EPI and in stage 3a by the creatinine/cystatin C-based BIS equation. A total of 27 participants were classified in stage 3a by creatinine-based CKD-EPI and in stage 3b by creatinine-based BIS equation, whereas 18 were classified as stage 3a by creatinine/cystatin C-based CKD-EPI and stage 3b by the creatinine/cystatin C-based BIS equation. Conclusions: Despite a fair overall concordance, the CKD-EPI and BIS equations cannot be considered interchangeable to assess estimated glomerular filtration rate in older people, and using creatinine/cystatin C-based rather than creatinine-based equations only marginally improves the concordance between CKD-EPI and BIS. Disagreement between equations might significantly impact the applications of stage-specific measures for managing CKD among older people. Geriatr Gerontol Int 2017; 17: 1559–1567.
Agreement between Chronic Kidney Disease Epidemiological Collaboration and Berlin Initiative Study equations for estimating glomerular filtration rate in older people: The Invecchiare in Chianti (Aging in Chianti Region) study
Corsonello A.;
2017-01-01
Abstract
Aim: The aim was to investigate to what extent chronic kidney disease (CKD) can be staged interchangeably by Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and by Berlin Initiative Study (BIS) equations, and to verify whether cystatin C can improve concordance between formulas. Methods: Our series consisted of 828 community-dwelling individuals aged 65 years or older enrolled in the Invecchiare in Chianti Study (“Aging in the Chianti Region”). Estimated glomerular filtration rate was calculated using the creatinine-based CKD-EPI, creatinine/cystatin C-based CKD-EPI, creatinine-based BIS and creatinine/cystatin C-based BIS equations. Agreement and sources of discrepancy between equations in identifying people with different degrees of kidney dysfunction was investigated by κ statistic and Bland–Altman plots. Results: Overall, CKD-EPI values were higher than that obtained with BIS equations, especially for eGFR = 30–60 mL/min/1.73 m2. A total of 191 out of 828 participants were classified in stage 2 by the creatinine-based CKD-EPI and in stage 3a by the creatinine-based BIS equation, whereas 123 participants were classified in stage 2 by creatinine/cystatin C-based CKD-EPI and in stage 3a by the creatinine/cystatin C-based BIS equation. A total of 27 participants were classified in stage 3a by creatinine-based CKD-EPI and in stage 3b by creatinine-based BIS equation, whereas 18 were classified as stage 3a by creatinine/cystatin C-based CKD-EPI and stage 3b by the creatinine/cystatin C-based BIS equation. Conclusions: Despite a fair overall concordance, the CKD-EPI and BIS equations cannot be considered interchangeable to assess estimated glomerular filtration rate in older people, and using creatinine/cystatin C-based rather than creatinine-based equations only marginally improves the concordance between CKD-EPI and BIS. Disagreement between equations might significantly impact the applications of stage-specific measures for managing CKD among older people. Geriatr Gerontol Int 2017; 17: 1559–1567.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
