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Comparison of the heart failure risk stratification performance of the CKD-EPI equation and the MDRD equation for estimated glomerular filtration rate in patients with Type 2 diabetes.
Diabet Med. 2016 May; 33(5):609-20.DM

Abstract

AIMS

To investigate the risk prediction and the risk stratification performances of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and the Modification of Diet in Renal Disease (MDRD) equation for estimated glomerular filtration rate (eGFRCKD - EPI vs. eGFRMDRD) on heart failure in patients with Type 2 diabetes.

METHODS

The study cohort included 12 258 White and 16 886 African American low-income patients with Type 2 diabetes who were 30-90 years old at baseline. Heart failure risk according to different eGFRCKD - EPI and eGFRMDRD categories was prospectively assessed.

RESULTS

During a mean follow-up of 6.5 years, 5043 incident heart failure cases were identified. Multivariable-adjusted hazard ratios (HRs) of heart failure associated with the eGFRCKD - EPI categories [≥ 90 (reference group), 75-89, 60-74, 30-59 and < 30 ml/min/1.73 m(2) ] were 1.00, 1.11, 1.31, 1.75 and 2.93 (Ptrend < 0.001) for African American patients, and 1.00, 1.11, 1.08, 1.59 and 2.92 (Ptrend < 0.001) for White patients, respectively. The model with eGFRCKD - EPI and the other risk factors had significantly higher Harrell's C than the model with eGFRMDRD and other risk factors. Patients reclassified downward from eGFRMDRD 60-74 to eGFRCKD - EPI 30-59 and from eGFRMDRD 30-59 to eGFRCKD - EPI < 30 ml/min/1.73 m(2) showed higher heart failure risk than those who were not reclassified.

CONCLUSIONS

Impaired kidney function (i.e. GFR < 60 ml/min/1.73 m(2)), and even mildly decreased GFR (60-74 ml/min/1.73 m(2)) estimated by both equations is associated with an increased risk of heart failure. Compared with GFR estimated using the MDRD equation, GFR estimated using the CKD-EPI equation added more predictive power to the model with the other risk factors. Also, eGFRCKD - EPI provided more accurate heart failure risk stratification than eGFRMDRD .

Authors+Show Affiliations

Pennington Biomedical Research Center, Baton Rouge, LA, USA.Pennington Biomedical Research Center, Baton Rouge, LA, USA.Pennington Biomedical Research Center, Baton Rouge, LA, USA.Pennington Biomedical Research Center, Baton Rouge, LA, USA.Health Care Service Division, Louisiana State University Health Science Center, Baton Rouge, LA, USA.Pennington Biomedical Research Center, Baton Rouge, LA, USA.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26202081

Citation

Wang, Y, et al. "Comparison of the Heart Failure Risk Stratification Performance of the CKD-EPI Equation and the MDRD Equation for Estimated Glomerular Filtration Rate in Patients With Type 2 Diabetes." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 33, no. 5, 2016, pp. 609-20.
Wang Y, Katzmarzyk PT, Horswell R, et al. Comparison of the heart failure risk stratification performance of the CKD-EPI equation and the MDRD equation for estimated glomerular filtration rate in patients with Type 2 diabetes. Diabet Med. 2016;33(5):609-20.
Wang, Y., Katzmarzyk, P. T., Horswell, R., Zhao, W., Johnson, J., & Hu, G. (2016). Comparison of the heart failure risk stratification performance of the CKD-EPI equation and the MDRD equation for estimated glomerular filtration rate in patients with Type 2 diabetes. Diabetic Medicine : a Journal of the British Diabetic Association, 33(5), 609-20. https://doi.org/10.1111/dme.12859
Wang Y, et al. Comparison of the Heart Failure Risk Stratification Performance of the CKD-EPI Equation and the MDRD Equation for Estimated Glomerular Filtration Rate in Patients With Type 2 Diabetes. Diabet Med. 2016;33(5):609-20. PubMed PMID: 26202081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the heart failure risk stratification performance of the CKD-EPI equation and the MDRD equation for estimated glomerular filtration rate in patients with Type 2 diabetes. AU - Wang,Y, AU - Katzmarzyk,P T, AU - Horswell,R, AU - Zhao,W, AU - Johnson,J, AU - Hu,G, Y1 - 2015/08/30/ PY - 2015/07/17/accepted PY - 2015/7/24/entrez PY - 2015/7/24/pubmed PY - 2017/1/7/medline SP - 609 EP - 20 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 33 IS - 5 N2 - AIMS: To investigate the risk prediction and the risk stratification performances of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and the Modification of Diet in Renal Disease (MDRD) equation for estimated glomerular filtration rate (eGFRCKD - EPI vs. eGFRMDRD) on heart failure in patients with Type 2 diabetes. METHODS: The study cohort included 12 258 White and 16 886 African American low-income patients with Type 2 diabetes who were 30-90 years old at baseline. Heart failure risk according to different eGFRCKD - EPI and eGFRMDRD categories was prospectively assessed. RESULTS: During a mean follow-up of 6.5 years, 5043 incident heart failure cases were identified. Multivariable-adjusted hazard ratios (HRs) of heart failure associated with the eGFRCKD - EPI categories [≥ 90 (reference group), 75-89, 60-74, 30-59 and < 30 ml/min/1.73 m(2) ] were 1.00, 1.11, 1.31, 1.75 and 2.93 (Ptrend < 0.001) for African American patients, and 1.00, 1.11, 1.08, 1.59 and 2.92 (Ptrend < 0.001) for White patients, respectively. The model with eGFRCKD - EPI and the other risk factors had significantly higher Harrell's C than the model with eGFRMDRD and other risk factors. Patients reclassified downward from eGFRMDRD 60-74 to eGFRCKD - EPI 30-59 and from eGFRMDRD 30-59 to eGFRCKD - EPI < 30 ml/min/1.73 m(2) showed higher heart failure risk than those who were not reclassified. CONCLUSIONS: Impaired kidney function (i.e. GFR < 60 ml/min/1.73 m(2)), and even mildly decreased GFR (60-74 ml/min/1.73 m(2)) estimated by both equations is associated with an increased risk of heart failure. Compared with GFR estimated using the MDRD equation, GFR estimated using the CKD-EPI equation added more predictive power to the model with the other risk factors. Also, eGFRCKD - EPI provided more accurate heart failure risk stratification than eGFRMDRD . SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/26202081/Comparison_of_the_heart_failure_risk_stratification_performance_of_the_CKD_EPI_equation_and_the_MDRD_equation_for_estimated_glomerular_filtration_rate_in_patients_with_Type_2_diabetes_ L2 - https://doi.org/10.1111/dme.12859 DB - PRIME DP - Unbound Medicine ER -