Original InvestigationPathogenesis and Treatment of Kidney DiseaseRisk Implications of the New CKD Epidemiology Collaboration (CKD-EPI) Equation Compared With the MDRD Study Equation for Estimated GFR: The Atherosclerosis Risk in Communities (ARIC) Study
Section snippets
Study Population
We analyzed data from participants in the Atherosclerosis Risk in Communities (ARIC) Study, a population-based cohort study of middle-aged individuals from 4 US communities: Forsyth County, NC; suburban Minneapolis, MN; Washington County, MD; and Jackson, MS. Details of the ARIC Study are described elsewhere.13 In brief, 15,792 men and women aged 45-64 years were enrolled from 1987 through 1989. In the present study, we excluded participants self-reporting race other than white or black (n =
Characteristics of Study Participants
Participants with CKD stage 3 (eGFRCKD-EPI of 30-59 mL/min/1.73 m2) or stage 4/5 (eGFRCKD-EPI < 30 mL/min/1.73 m2) were more likely to be older, women, and black and have more comorbid conditions, including diabetes, compared with individuals with eGFRCKD-EPI of 90-119 mL/min/1.73 m2 (Table 1). The category of eGFRCKD-EPI ≥ 120 mL/min/1.73 m2 mainly consisted of black women who also tended to have a higher prevalence of diabetes and left ventricular hypertrophy, more often reported using
Discussion
Overall, our results suggest that categorization of kidney function using the CKD-EPI equation more appropriately stratifies middle-aged individuals according to risk of important clinical outcomes compared with the conventional MDRD Study equation. The prevalence of CKD stage 3 (eGFR, 30-59 mL/min/1.73 m2) at baseline was decreased from 2.5% (n = 347) to 1.4% (n = 196) comparing the CKD-EPI and MDRD Study equations in a large community-based middle-aged population. Importantly, participants
Acknowledgements
The authors thank the staff and participants of the ARIC Study for their important contributions.
Support: The ARIC Study is carried out as a collaborative study supported by National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI) contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. Dr Matsushita was supported by a grant from the Japan Society for the Promotion of Science. Dr Selvin was supported by the NIH
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Originally published online as doi:10.1053/j.ajkd.2009.12.016 on March 2, 2010.
Because the Editor-in-Chief recused himself from consideration of this manuscript, the Deputy Editor (Daniel E. Weiner, MD, MS) served as Acting Editor-in-Chief. Details of the journal's procedures for potential editor conflicts are given in the Editorial Policies section of the AJKD website.