Clinical Implications of Estimating Glomerular Filtration Rate with Three Different Equations among Older People. Preliminary Results of the Project “Screening for Chronic Kidney Disease among Older People across Europe (SCOPE)”
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Variables
2.2. Analytic Approach
2.3. Ethical Statement
- Italian National Research Center on Aging (INRCA), Italy, #2015 0522 IN, 27 January 2016.
- University of Lodz, Poland, #RNN/314/15/KE, 17 November 2015.
- Medizinische Universität Graz, Austria, #28–314 ex 15/16, 5 August 2016
- Erasmus Medical Center Rotterdam, The Netherland, #MEC-2016-036 - #NL56039.078.15, v.4, 7 March 2016.
- Hospital Clínico San Carlos, Madrid, Spain, # 15/532-E_BC, 16 September 2016
- Bellvitge University Hospital Barcellona, Spain, #PR204/15, 29 January 2016.
- Friedrich-Alexander University Erlangen-Nürnberg, Germany, #340_15B, 21 January 2016.
- Helsinki committee in Maccabi Healthcare services, Bait Ba-lev, Bat Yam, Israel, #45/2016, 24 July 2016.
3. Results
4. Discussion
5. Limitations and Strengths
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
- Department of Internal Medicine, Medical University of Graz, Austria: Gerhard Hubert Wirnsberger, Regina Elisabeth Roller-Wirnsberger, Carolin Herzog, Sonja Lindner
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, The Netherlands: Francesco Mattace-Raso, Lisanne Tap, Gijsbertus Ziere, Jeannette Goudzwaard.
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Poland: Tomasz Kostka, Agnieszka Guligowska, Łukasz Kroc, Bartłomiej K Sołtysik, Małgorzata Pigłowska, Agnieszka Wójcik, Zuzanna Chrząstek, Natalia Sosowska, Anna Telążka, Joanna Kostka, Elizaveta Fife, Katarzyna Smyj.
- The Recanati School for Community Health Professions at the faculty of Health Sciences at Ben-Gurion University of the Negev, Israel: Rada Artzi-Medvedik, Yehudit Melzer, Mark Clarfield, Itshak Melzer; and Maccabi Healthcare services southern region, Israel: Rada Artzi-Medvedik, Ilan Yehoshua, Yehudit Melzer.
- Geriatric Unit, Internal Medicine Department and Nephrology Department, Bellvitge University Hospital–IDIBELL–L’Hospitalet de Llobregat, Barcelona, Spain: Francesc Formiga-Perez, Rafael Moreno-González, Josep Maria Cruzado.
- Department of Geriatric Medicine, Hospital Clínico San Carlos, Madrid: Pedro Gil Gregorio, Jose A. Herrero Calvo, Fernando Tornero Molina, Lara Guardado Fuentes, Pamela Carrillo García, María Mombiedro Pérez.
- Department of General Internal Medicine and Geriatrics, Krankenhaus Barmherzige Brüder Regensburg and Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany: Christian Weingart, Ellen Freiberger, Cornel Sieber.
- Department of Medical Sciences, Uppsala University, Sweden: Johan Ärnlöv, Axel Carlsson, Tobias Feldreich.
Conflicts of Interest
References
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Reference Study | Equation | |
---|---|---|
CKD-EPI [8] | Women (Scr ≤ 0.7) (Scr > 0.7) | eGFR = 144 × (Scr/0.7)−0.329 × (0.993)Age eGFR = 144 × (Scr/0.7)−1.209 × (0.993)Age |
Men (Scr ≤ 0.9) (Scr > 0.9) | eGFR = 141 × (Scr/0.9)−0.411 × (0.993)Age eGFR = 141 × (Scr/0.9)−1.209 × (0.993)Age | |
BIS [9] | 3736 × creatinine−0.87 × age−0.95 × 0.82 (if women) | |
FAS [11] | (107.3/(creatinine/Q)) × 0.988(Age-40) for age >40 years Q = median Scr value for age-/sex-specific healthy populations |
All Patients N = 2257 | Women N = 1256 | Men N = 1001 | p-Value | ||
---|---|---|---|---|---|
Age, years | 80.3 ± 4.1 | 80.3 ± 4.1 | 80.4 ± 4.1 | 0.671 | |
Sex, women | 1256 (55.6) | - | - | - | |
Body mass index, kg/m2 | 27.8 ± 4.7 | 27.9 ± 4.9 | 27.6 ± 4.5 | 0.153 | |
Serum creatinine, mg/dL | 1.11 ± 0.56 | 0.93 ± 0.41 | 1.33 ± 0.64 | <0.001 | |
CKD-EPI eGFR, mL/min/1.73 m2 | 63.8 ± 19.4 | 65.4 ± 18.1 | 58.9 ± 20.5 | <0.001 | |
90 or more | 43 (1.9) | 32 (2.5) | 11 (1.1) | ||
60–90 | 1335 (59.1) | 807 (64.3) | 528 (52.7) | ||
45–60 | 433 (19.2) | 240 (19.1) | 193 (19.3) | ||
30–45 | 271 (12.0) | 112 (8.9) | 159 (15.9) | ||
<30 | 175 (7.8) | 65 (5.2) | 110 (11.0) | ||
BIS eGFR, mL/min/1.73 m2 | 54.6 ± 15.2 | 55.5 ± 14.8 | 51.1 ± 14.9 | <0.001 | |
90 or more | 9 (0.4) | 7 (0.6) | 2 (0.2) | ||
60–90 | 759 (33.6) | 471 (37.5) | 288 (28.8) | ||
45–60 | 877 (38.9) | 499 (39.7) | 378 (37.8) | ||
30–45 | 451 (20.0) | 213 (17.0) | 238 (23.8) | ||
<30 | 161 (7.1) | 66 (5.3) | 95 (9.5) | ||
FAS eGFR, mL/min/1.73 m2 | 55.0 ± 17.3 | 55.4 ± 16.9 | 51.7 ± 17.0 | <0.001 | |
90 or more | 29 (1.3) | 18 (1.4) | 11 (1.1) | ||
60–90 | 775 (34.3) | 467 (37.2) | 308 (30.8) | ||
45–60 | 791 (35.0) | 454 (36.1) | 337 (33.7) | ||
30–45 | 450 (19.9) | 227 (18.1) | 223 (22.3) | ||
<30 | 212 (9.4) | 90 (7.2) | 122 (12.2) | ||
ACR, mg/g | 100 ± 480 | 77.1 ± 390 | 177 ± 599 | <0.001 | |
<30 | 1648 (73.0) | 992 (79.0) | 656 (65.5) | ||
30–300 | 458 (20.3) | 216 (17.2) | 242 (24.2) | ||
>300 | 151 (6.7) | 48 (3.8) | 103 (10.3) | ||
Muscle mass, kg (N = 1462) | 22.7 ± 6.8 | 18.0 ± 3.8 | 29.0 ± 4.4 | <0.001 | |
Short Physical Performance Battery score | 8.7 ± 2.9 | 8.3 ± 3.1 | 9.3 ± 2.7 | <0.001 | |
Hypertension | 1734 (76.8) | 972 (76.6) | 772 (77.1) | 0.767 | |
Diabetes Mellitus | 569 (25.2) | 264 (21.0) | 305 (30.5) | <0.001 | |
Heart Failure | 373 (16.5) | 182 (14.5) | 191 (19.1) | 0.004 | |
Atrial fibrillation | 344 (15.2) | 165 (1.1) | 179 (17.9) | 0.002 | |
Myocardial infarction | 217 (9.6) | 75 (6.0) | 142 (14.2) | <0.001 | |
Stroke | 131 (5.8) | 61 (4.9) | 70 (7.0) | 0.031 |
All Patients, N = 2257 | Men, N = 1001 | Women, N = 1256 | |||||||
---|---|---|---|---|---|---|---|---|---|
CKD-EPI | ACR (mg/g) | ACR (mg/g) | ACR (mg/g) | ||||||
<30 | 30–300 | >300 | <30 | 30–300 | >300 | <30 | 30–300 | >300 | |
G1 (90 or more) | 35 2.1% | 7 1.5% | 1 0.7% | 8 1.2% | 3 1.3% | 0 | 27 2.7% | 4 1.8% | 1 2.1% |
G2 (60-90) | 1133 68.8% | 188 41.3% | 13 8.6% | 433 65.9% | 86 36.1% | 9 8.7% | 700 70.7% | 102 47.0% | 4 8.3% |
G3A (45-60) | 311 18.9% | 98 21.5% | 24 15.8% | 128 19.5% | 50 21.0% | 15 14.4% | 183 18.5% | 48 22.1% | 9 18.8% |
G3B (30-45) | 133 8.1% | 84 18.5% | 51 33.6% | 69 10.5% | 52 21.8% | 36 34.6% | 64 6.5% | 32 14.7% | 15 31.3% |
G4-5 (<30) | 35 2.1% | 78 17.1% | 63 41.4% | 19 2.9% | 47 19.7% | 44 42.3% | 19 2.9% | 31 14.3% | 19 39.6% |
BIS | |||||||||
G1 (90 or more) | 6 0.3% | 3 0.8% | 0 | 1 0.2% | 1 0.4% | 0 | 5 0.5% | 2 0.9% | 0 |
G2 (60-90) | 655 39.8% | 97 21.3% | 7 4.6% | 247 37.6% | 37 15.5% | 5 4.8% | 408 41.3% | 60 27.6% | 2 4.2% |
G3A (45-60) | 710 43.1% | 143 31.4% | 23 15.1% | 285 43.4% | 80 33.6% | 12 11.5% | 425 42.9% | 63 29.0% | 11 22.9% |
G3B (30-45) | 244 14.8% | 140 30.8% | 64 42.1% | 109 16.6% | 79 33.2% | 48 46.2% | 135 13.6% | 61 28.1% | 16 33.3% |
G4-5 (<30) | 32 1.9% | 72 15.8% | 58 38.2% | 15 2.3% | 41 17.2% | 39 37.5% | 17 1.7% | 31 14.3% | 19 39.6% |
FAS | |||||||||
G1 (90 or more) | 22 1.3% | 6 1.3% | 1 0.7% | 8 1.2% | 3 1.3% | 0 | 14 1.4% | 3 1.4% | 1 2.1% |
G2 (60-90) | 669 40.7% | 101 22.2% | 6 3.9% | 263 40.0% | 42 17.6% | 5 4.8% | 406 41.1% | 59 27.2% | 1 2.1% |
G3A (45-60) | 641 38.9% | 131 28.8% | 17 11.2% | 254 38.7% | 72 30.3% | 9 8.7% | 387 39.1% | 59 27.2% | 8 16.7% |
G3B (30-45) | 267 16.2% | 127 27.9% | 53 34.9% | 109 16.6% | 72 30.3% | 40 30.5% | 158 16.0% | 55 25.3% | 13 27.1% |
G4-5 (<30) | 48 2.9% | 90 19.8% | 75 49.3% | 23 3.5% | 49 20.6 | 50 48.1% | 25 2.5% | 41 18.9% | 25 52.1% |
CKD-EPI | ||||||||
90 OR MORE (N = 43) | 90-60 (N = 1335) | 60-45 (N = 433) | 45-30 (N = 271) | <30 (N = 175) | κ | p | ||
0.47 | 0.001 | |||||||
FAS | 90 OR MORE | 29 | ||||||
67.4% | ||||||||
90-60 | 14 | 761 | ||||||
32.6% | 57.0% | |||||||
60-45 | 574 | 217 | ||||||
43.0% | 50.1% | |||||||
45-30 | 216 | 234 | ||||||
49.9% | 86.3% | |||||||
<30 | 37 | 175 | ||||||
13.7% | 100.0% | |||||||
0.47 | 0.001 | |||||||
BIS | 90 OR MORE | 9 | ||||||
20.9% | ||||||||
90-60 | 34 | 725 | ||||||
79.1% | 54.3% | |||||||
60-45 | 610 | 267 | ||||||
45.7% | 61.7% | |||||||
45-30 | 166 | 267 | 18 | |||||
38.3% | 98.5% | 10.3% | ||||||
<30 | 4 | 157 | ||||||
1.5% | 89.7% | |||||||
BIS | ||||||||
90 OR MORE (N = 9) | 90-60 (N = 759) | 60-45 (N = 877) | 45-30 (N = 451) | <30 (N = 161) | κ | p | ||
0.90 | 0.001 | |||||||
FAS | 90 OR MORE | 9 | 20 | |||||
100.0% | 2.6% | |||||||
90-60 | 738 | 37 | ||||||
97.2% | 4.2% | |||||||
60-45 | 1 | 790 | ||||||
0.1% | 90.1% | |||||||
45-30 | 50 | 400 | ||||||
5.7% | 88.7% | |||||||
<30 | 51 | 161 | ||||||
11.3% | 100.0% |
CKD-EPI | ||||||||
90 OR MORE (N = 32) | 90-60 (N = 807) | 60-45 (N = 240) | 45-30 (N = 112) | <30 (N = 65) | κ | p | ||
0.36 | 0.001 | |||||||
FAS | 90 OR MORE | 18 | ||||||
56.3% | ||||||||
90-60 | 14 | 453 | ||||||
43.8% | 56.1% | |||||||
60-45 | 354 | 100 | ||||||
43.9% | 41.7% | |||||||
45-30 | 140 | 87 | ||||||
58.3% | 77.7% | |||||||
<30 | 25 | 65 | ||||||
22.3% | 100.0% | |||||||
0.41 | 0.001 | |||||||
BIS | 90 OR MORE | 7 | ||||||
21.9% | ||||||||
90-60 | 25 | 446 | ||||||
78.1% | 55.3% | |||||||
60-45 | 361 | 138 | ||||||
44.7% | 57.5% | |||||||
45-30 | 102 | 109 | 2 | |||||
42.5% | 97.3% | 3.1% | ||||||
<30 | 3 | 63 | ||||||
2.7% | 96.9% | |||||||
BIS | ||||||||
90 OR MORE (N = 7) | 90-60 (N = 471) | 60-45 (N = 499) | 45-30 (N = 213) | <30 (N = 66) | κ | p | ||
0.90 | 0.001 | |||||||
FAS | 90 OR MORE | 7 | 11 | |||||
100.0% | 2.3% | |||||||
90-60 | 459 | 8 | ||||||
97.5% | 1.6% | |||||||
60-45 | 1 | 453 | ||||||
0.2% | 90.8% | |||||||
45-30 | 38 | 188 | ||||||
7.6% | 88.7% | |||||||
<30 | 24 | 66 | ||||||
11.3% | 100.0% |
CKD-EPI | ||||||||
90 OR MORE (N = 11) | 90-60 (N = 528) | 60-45 (N = 193) | 45-30 (N = 159) | <30 (N = 110) | κ | p | ||
0.57 | 0.001 | |||||||
FAS | 90 OR MORE | 11 | ||||||
100% | ||||||||
90-60 | 308 | |||||||
58.3% | ||||||||
60-45 | 220 | 117 | ||||||
41.7% | 60.6% | |||||||
45-30 | 76 | 147 | ||||||
39.4% | 92.5% | |||||||
<30 | 12 | 110 | ||||||
7.5% | 100.0% | |||||||
0.53 | 0.001 | |||||||
BIS | 90 OR MORE | 2 | ||||||
18.2% | ||||||||
90-60 | 9 | 279 | ||||||
81.8% | 52.8% | |||||||
60-45 | 249 | 129 | ||||||
47.2% | 66.8% | |||||||
45-30 | 64 | 158 | 16 | |||||
33.2% | 99.4% | 14.5% | ||||||
<30 | 1 | 94 | ||||||
0.6% | 85.5% | |||||||
BIS | ||||||||
90 OR MORE (N = 2) | 90-60 (N = 288) | 60-45 (N = 378) | 45-30 (N = 238) | <30 (N = 95) | κ | p | ||
0.89 | 0.001 | |||||||
FAS | 90 OR MORE | 2 | 9 | |||||
100.0% | 3.1% | |||||||
90-60 | 279 | 29 | ||||||
96.9% | 7.7% | |||||||
60-45 | 337 | |||||||
89.2% | ||||||||
45-30 | 12 | 211 | ||||||
3.2% | 88.7% | |||||||
<30 | 27 | 95 | ||||||
11.3% | 100.0% |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Corsonello, A.; Roller-Wirnsberger, R.; Wirnsberger, G.; Ärnlöv, J.; Carlsson, A.C.; Tap, L.; Mattace-Raso, F.; Formiga, F.; Moreno-Gonzalez, R.; Weingart, C.; et al. Clinical Implications of Estimating Glomerular Filtration Rate with Three Different Equations among Older People. Preliminary Results of the Project “Screening for Chronic Kidney Disease among Older People across Europe (SCOPE)”. J. Clin. Med. 2020, 9, 294. https://doi.org/10.3390/jcm9020294
Corsonello A, Roller-Wirnsberger R, Wirnsberger G, Ärnlöv J, Carlsson AC, Tap L, Mattace-Raso F, Formiga F, Moreno-Gonzalez R, Weingart C, et al. Clinical Implications of Estimating Glomerular Filtration Rate with Three Different Equations among Older People. Preliminary Results of the Project “Screening for Chronic Kidney Disease among Older People across Europe (SCOPE)”. Journal of Clinical Medicine. 2020; 9(2):294. https://doi.org/10.3390/jcm9020294
Chicago/Turabian StyleCorsonello, Andrea, Regina Roller-Wirnsberger, Gerhard Wirnsberger, Johan Ärnlöv, Axel C. Carlsson, Lisanne Tap, Francesco Mattace-Raso, Francesc Formiga, Rafael Moreno-Gonzalez, Christian Weingart, and et al. 2020. "Clinical Implications of Estimating Glomerular Filtration Rate with Three Different Equations among Older People. Preliminary Results of the Project “Screening for Chronic Kidney Disease among Older People across Europe (SCOPE)”" Journal of Clinical Medicine 9, no. 2: 294. https://doi.org/10.3390/jcm9020294