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Comparison of the C...
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Szummer, Karolina
(författare)
Comparison of the Chronic Kidney Disease Epidemiology Collaboration, the Modification of Diet in Renal Disease study and the Cockcroft-Gault equation in patients with heart failure
- E-artikel/E-kapitelEngelska2017
Förlag, utgivningsår, omfång ...
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Gateshead, United KingdomOpen House International Association2017
Nummerbeteckningar
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LIBRIS-ID:22431674
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http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-144357uri
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urn:nbn:se:liu:diva-144357urn
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10.1136/openhrt-2016-000568doi
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BACKGROUND: It is unknown how the creatinine-based renal function estimations differ for dose adjustment cut-offs and risk prediction in patients with heart failure. METHOD AND RESULTS: The renal function was similar with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (median 59 mL/min/1.73 m2, IQR 42 to 77) and Modification of Diet in Renal Disease Study (MDRD) (59 mL/min/1.73 m2, IQR 43 to 75) and slightly lower with the Cockcroft-Gault (CG) equation (57 mL/min, IQR 39 to 82). Across the commonly used renal function stages, the CKD-EPI and the MDRD classified patients into the same stage in 87.2% (kappa coefficient 0.83, p<0.001); the CKD-EPI and the CG equation agreed in 52.3% (kappa coefficient 0.39, p<0.001). Hence, a differing number of patients will receive dose adjustment depending on which formula is used as cut-off. The CG equation predicted worse prognosis better (c-statistics 0.740, 95% CI 0.734 to 0.746) than CKD-EPI (0.697, 95% CI 0.690 to 0.703, p<0.001) and MDRD (0.680, 95% CI 0.734 to 0.746). Using net reclassification improvement (NRI), the CG identified 12.8% more patients at higher risk of death as compared with the CKD-EPI equation. Patients registered in the Swedish Heart Failure Registry (n= 40 736) with standardised creatinine values between 2000 and 2012 had their renal function estimated with the CKD-EPI, the MDRD and the CG. Agreement between the formulas was compared for categories. Prediction of death was assessed with c-statistics and with NRI. CONCLUSION: The choice of renal function estimation formula has clinical implications and differing results at various cut-off levels. For prognosis, the CG predicts mortality better than the CKD-EPI and MDRD.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Evans, Marie
(författare)
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Carrero, Juan Jesus
(författare)
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Alehagen, Urban1951-228339
(författare)
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Dahlström, Ulf1946-409195
(författare)
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Benson, Lina
(författare)
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Lund, Lars H
(författare)
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Linköpings universitetInstitutionen för medicin och hälsa308697
(utgivare)
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Linköpings universitetMedicinska fakulteten
(utgivare)
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Region ÖstergötlandHjärt- och Medicincentrum
(utgivare)
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Del av/supplement till:channel record
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Ingår i:VärdpublikationOpen heart4:20168-2601
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