TY - JOUR
T1 - Comparison of the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations
T2 - Prevalence of and risk factors for diabetes mellitus in CKD in the Kidney Early Evaluation Program (KEEP)
AU - McFarlane, Samy I.
AU - McCullough, Peter A.
AU - Sowers, James R.
AU - Soe, Kyaw
AU - Chen, Shu Cheng
AU - Li, Suying
AU - Vassalotti, Joseph A.
AU - Stevens, Lesley A.
AU - Salifu, Moro O.
AU - Kurella Tamura, Manjula
AU - Bomback, Andrew S.
AU - Norris, Keith C.
AU - Collins, Allan J.
AU - Bakris, George L.
AU - Whaley-Connell, Adam T.
N1 - Funding Information:
Support: The KEEP is a program of the National Kidney Foundation Inc and is supported by Amgen , Abbott , Siemens , Astellas , Fresenius Medical Care , Genzyme , LifeScan , Nephroceuticals , and Pfizer . Dr Stevens receives grant support from Gilead Inc . Dr Whaley-Connell is supported by the Veteran's Affairs Career Development Award-2 . Dr Norris is supported by National Institutes of Health grants MD00182 and RR026138 .
PY - 2011/3
Y1 - 2011/3
N2 - Background: Diabetes is a leading cause of chronic kidney disease (CKD). Whether reclassification of CKD stages based on glomerular filtration rate estimated using the CKD Epidemiology Collaboration (CKD-EPI) equation versus the Modification of Diet in Renal Disease (MDRD) Study equation modifies estimates of prevalent risk factors across stages is unknown. Methods: This is a cross-sectional analysis of data from the Kidney Early Evaluation Program (KEEP), a community-based health screening program targeting individuals 18 years and older with diabetes, hypertension, or a family history of diabetes, hypertension, or kidney disease. Of 109,055 participants, 68.2% were women and 31.8% were African American. Mean age was 55.3 ± 0.05 years. Clinical, demographic, and laboratory data were collected from August 2000 through December 2009. Glomerular filtration rate was estimated using the CKD-EPI and MDRD Study equations. Results: CKD was present in 25.6% and 23.5% of the study population using the MDRD Study and CKD-EPI equations, respectively. Diabetes was present in 42.4% and 43.8% of participants with CKD, respectively. Prevalent risk factors for diabetes included obesity (body mass index >30 kg/m 2), 44.0%; hypertension, 80.5%; cardiovascular disease, 23.2%; family history of diabetes, 55.9%; and dyslipidemia, 43.0%. In a logistic regression model after adjusting for age and other risk factors, odds for diabetes increased significantly compared with no CKD with each CKD stage based on the CKD-EPI equation and similarly with stages based on the MDRD Study equation. Using a CKD-EPI-adjusted model, ORs were: stage 1, 2.08 (95% CI, 1.90-2.27); stage 2, 1.86 (95% CI, 1.72-2.02); stage 3, 1.23 (95% CI, 1.17-1.30); stage 4, 1.69 (95% CI, 1.42-2.03); and stage 5, 2.46 (95% CI, 1.46-4.14). Conclusions: Using the CKD-EPI equation led to a lower prevalence of CKD but to similar diabetes prevalence rates associated with CKD across all stages compared with the MDRD Study equation. Diabetes and other CKD risk factor prevalence was increased compared with the non-CKD population.
AB - Background: Diabetes is a leading cause of chronic kidney disease (CKD). Whether reclassification of CKD stages based on glomerular filtration rate estimated using the CKD Epidemiology Collaboration (CKD-EPI) equation versus the Modification of Diet in Renal Disease (MDRD) Study equation modifies estimates of prevalent risk factors across stages is unknown. Methods: This is a cross-sectional analysis of data from the Kidney Early Evaluation Program (KEEP), a community-based health screening program targeting individuals 18 years and older with diabetes, hypertension, or a family history of diabetes, hypertension, or kidney disease. Of 109,055 participants, 68.2% were women and 31.8% were African American. Mean age was 55.3 ± 0.05 years. Clinical, demographic, and laboratory data were collected from August 2000 through December 2009. Glomerular filtration rate was estimated using the CKD-EPI and MDRD Study equations. Results: CKD was present in 25.6% and 23.5% of the study population using the MDRD Study and CKD-EPI equations, respectively. Diabetes was present in 42.4% and 43.8% of participants with CKD, respectively. Prevalent risk factors for diabetes included obesity (body mass index >30 kg/m 2), 44.0%; hypertension, 80.5%; cardiovascular disease, 23.2%; family history of diabetes, 55.9%; and dyslipidemia, 43.0%. In a logistic regression model after adjusting for age and other risk factors, odds for diabetes increased significantly compared with no CKD with each CKD stage based on the CKD-EPI equation and similarly with stages based on the MDRD Study equation. Using a CKD-EPI-adjusted model, ORs were: stage 1, 2.08 (95% CI, 1.90-2.27); stage 2, 1.86 (95% CI, 1.72-2.02); stage 3, 1.23 (95% CI, 1.17-1.30); stage 4, 1.69 (95% CI, 1.42-2.03); and stage 5, 2.46 (95% CI, 1.46-4.14). Conclusions: Using the CKD-EPI equation led to a lower prevalence of CKD but to similar diabetes prevalence rates associated with CKD across all stages compared with the MDRD Study equation. Diabetes and other CKD risk factor prevalence was increased compared with the non-CKD population.
KW - Chronic kidney disease
KW - diabetes mellitus
KW - estimated glomerular filtration rate
UR - http://www.scopus.com/inward/record.url?scp=79951860887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79951860887&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2010.11.009
DO - 10.1053/j.ajkd.2010.11.009
M3 - Article
C2 - 21338847
AN - SCOPUS:79951860887
SN - 0272-6386
VL - 57
SP - S24-S31
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 3 SUPPL. 2
ER -