Modification of Diet in Renal Disease (MDRD) study and CKD Epidemiology Collaboration (CKD-EPI) equations for Taiwanese adults
Journal
PLoS ONE
Journal Volume
9
Journal Issue
6
Pages
e99645
Date Issued
2014
Author(s)
Abstract
Background: Estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) study or the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations may not be accurate for Asians; thus, we developed modified eGFR equations for Taiwanese adults. Methods: This cross-sectional study compared the Taiwanese eGFR equations, the MDRD study, and the CKD-EPI equations with inulin clearance (Cin). A total of 695 adults including 259 healthy volunteers and 436 CKD patients were recruited. Participants from the Kaohsiung Medical University Hospital were used as the development set (N = 556) to develop the Taiwanese eGFR equations, whereas participants from the National Taiwan University Hospital were used as the validation set (N = 139) for external validation. Results: The Taiwanese eGFR equations were developed by using the extended Bland-Altman plot in the development set. The Taiwanese MDRD equation was 1.309×MDRD 0.912, Taiwanese CKD-EPI was 1.262×CKD-EPI0.914 and Taiwanese four-level CKD-EPI was 1.205×four-level CKD-EPI0.914. In the validation set, the Taiwanese equations had the lowest bias, the Taiwanese equations and the Japanese CKD-EPI equation had the lowest RMSE, whereas the Taiwanese and the Japanese equations had the best precision and the highest P30 among all equations. However, the Taiwanese MDRD equation had higher concordance correlation than did the Taiwanese CKD-EPI, the Taiwanese four-level CKD-EPI and the Japanese equations. Moreover, only the Taiwanese equations had no proportional bias among all of the equations. Finally, the Taiwanese MDRD equation had the best diagnostic performance in terms of ordinal logistic regression among all of the equations. Conclusion: The Taiwanese MDRD equation is better than the MDRD, CKD-EPI, Japanese, Asian, Thai, Taiwanese CKD-EPI, and Taiwanese four-level CKD-EPI equations for Taiwanese adults. ? 2014 Chen et al.
SDGs
Other Subjects
inulin; accuracy; adult; article; bootstrapping; chronic kidney disease; Chronic Kidney Disease Epidemiology Collaboration equation; controlled study; cross-sectional study; diagnostic test accuracy study; diagnostic value; estimated glomerular filtration rate equation; external validity; female; glomerulus filtration rate; human; intermethod comparison; inulin clearance; Japan; major clinical study; male; Modification of Diet in Renal Disease equation; prevalence; process development; renal diet; statistical parameters; Taiwan; validation process; blood; comparative study; diagnostic use; kidney; middle aged; pathophysiology; Renal Insufficiency, Chronic; risk factor; Adult; Cross-Sectional Studies; Female; Glomerular Filtration Rate; Humans; Inulin; Japan; Kidney; Male; Middle Aged; Renal Insufficiency, Chronic; Risk Factors; Taiwan
Publisher
Public Library of Science
Type
journal article