KEEP 2010Comparison of the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study Equations: Risk Factors for and Complications of CKD and Mortality in the Kidney Early Evaluation Program (KEEP)
Section snippets
Study Participants
We included 123,704 eligible KEEP participants, August 2000 through December 31, 2009, from 48 NKF affiliates and 2,634 screening programs in 50 states and the District of Columbia. We excluded participants with missing CKD data, leaving a study population of 116,321.
GFR Estimation
GFR was estimated using the 4-variable MDRD Study equation8 (eGFRMDRD) and the CKD-EPI equation3 (eGFRCKD-EPI): where SCr is serum
Results
The median value for eGFRCKD-EPI was higher than for eGFRMDRD (85.5 [interquartile range, 31] vs 79.2 [interquartile range, 43] mL/min/1.73 m2). Participants in lower eGFR categories determined using eGFRCKD-EPI were more likely to be older, male, and white and have higher blood pressure than participants in higher categories (Table 1). They also were more likely to be anemic and have chronic conditions, such as diabetes, hypertension, coronary artery disease, congestive heart failure, and
Discussion
GFR is used in many clinical settings. In KEEP, it is used to identify people with CKD and assess CKD severity. In this study, we show that compared with the MDRD Study equation, use of the CKD-EPI equation resulted in a lower prevalence of eGFR <60 mL/min/1.73 m2 and more participants classified to higher eGFR categories. Participants who were reclassified to higher categories using eGFRCKD-EPI were less likely to have CKD risk factors or comorbid conditions and were at lower risk of death
Acknowledgements
The authors thank Shane Nygaard, BA, and Nan Booth, MSW, MPH, ELS, of the Chronic Disease Group for manuscript preparation and editing, respectively.
Support: This study was supported by grant K23-DK081017, Kidney Function and Aging, from the National Institute of Diabetes and Digestive and Kidney Diseases. The KEEP is a program of the NKF Inc and is supported by Amgen, Abbott, Siemens, Astellas, Fresenius Medical Care, Genzyme, LifeScan, Nephroceuticals, and Pfizer. Dr Stevens receives grant
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