Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate

Kunihiro Matsushita, Bakhtawar K Mahmoodi, Mark Woodward, Jonathan Emberson, Tazeen H Jafar, Sun Ha Jee, Kevan R Polkinghorne, Anoop Shankar, David H Smith, Marcello Tonelli, David G Warnock, Chi Pang Wen, Josef Coresh, Ron T Gansevoort, Brenda Hemmelgarn, Andrew S Levey

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Abstract

CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk implications in diverse settings is lacking. OBJECTIVE: To evaluate risk implications of estimated GFR using the CKD-EPI equation compared with the MDRD Study equation in populations with a broad range of demographic and clinical characteristics. DESIGN, SETTING, AND PARTICIPANTS: A meta-analysis of data from 1.1 million adults (aged >/= 18 years) from 25 general population cohorts, 7 high-risk cohorts (of vascular disease), and 13 CKD cohorts. Data transfer and analyses were conducted between March 2011 and March 2012. MAIN OUTCOME MEASURES: All-cause mortality (84,482 deaths from 40 cohorts), cardiovascular mortality (22,176 events from 28 cohorts), and end-stage renal disease (ESRD) (7644 events from 21 cohorts) during 9.4 million person-years of follow-up; the median of mean follow-up time across cohorts was 7.4 years (interquartile range, 4.2-10.5 years). RESULTS: Estimated GFR was classified into 6 categories (>/=90, 60-89, 45-59, 30-44, 15-29, and /=65 years), sex, race/ethnicity (white, Asian, and black), and presence or absence of diabetes and hypertension. The results in the high-risk and CKD cohorts were largely consistent with the general population cohorts. CONCLUSION: The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and ESRD than did the MDRD Study equation across a broad range of populations.
Original languageEnglish
Pages (from-to)1941 - 1951
Number of pages11
JournalJAMA
Volume307
Issue number18
DOIs
Publication statusPublished - 2012

Cite this

Matsushita, K., Mahmoodi, B. K., Woodward, M., Emberson, J., Jafar, T. H., Jee, S. H., ... Levey, A. S. (2012). Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate. JAMA, 307(18), 1941 - 1951. https://doi.org/10.1001/jama.2012.3954
Matsushita, Kunihiro ; Mahmoodi, Bakhtawar K ; Woodward, Mark ; Emberson, Jonathan ; Jafar, Tazeen H ; Jee, Sun Ha ; Polkinghorne, Kevan R ; Shankar, Anoop ; Smith, David H ; Tonelli, Marcello ; Warnock, David G ; Wen, Chi Pang ; Coresh, Josef ; Gansevoort, Ron T ; Hemmelgarn, Brenda ; Levey, Andrew S. / Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate. In: JAMA. 2012 ; Vol. 307, No. 18. pp. 1941 - 1951.
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title = "Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate",
abstract = "CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk implications in diverse settings is lacking. OBJECTIVE: To evaluate risk implications of estimated GFR using the CKD-EPI equation compared with the MDRD Study equation in populations with a broad range of demographic and clinical characteristics. DESIGN, SETTING, AND PARTICIPANTS: A meta-analysis of data from 1.1 million adults (aged >/= 18 years) from 25 general population cohorts, 7 high-risk cohorts (of vascular disease), and 13 CKD cohorts. Data transfer and analyses were conducted between March 2011 and March 2012. MAIN OUTCOME MEASURES: All-cause mortality (84,482 deaths from 40 cohorts), cardiovascular mortality (22,176 events from 28 cohorts), and end-stage renal disease (ESRD) (7644 events from 21 cohorts) during 9.4 million person-years of follow-up; the median of mean follow-up time across cohorts was 7.4 years (interquartile range, 4.2-10.5 years). RESULTS: Estimated GFR was classified into 6 categories (>/=90, 60-89, 45-59, 30-44, 15-29, and /=65 years), sex, race/ethnicity (white, Asian, and black), and presence or absence of diabetes and hypertension. The results in the high-risk and CKD cohorts were largely consistent with the general population cohorts. CONCLUSION: The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and ESRD than did the MDRD Study equation across a broad range of populations.",
author = "Kunihiro Matsushita and Mahmoodi, {Bakhtawar K} and Mark Woodward and Jonathan Emberson and Jafar, {Tazeen H} and Jee, {Sun Ha} and Polkinghorne, {Kevan R} and Anoop Shankar and Smith, {David H} and Marcello Tonelli and Warnock, {David G} and Wen, {Chi Pang} and Josef Coresh and Gansevoort, {Ron T} and Brenda Hemmelgarn and Levey, {Andrew S}",
year = "2012",
doi = "10.1001/jama.2012.3954",
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pages = "1941 -- 1951",
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Matsushita, K, Mahmoodi, BK, Woodward, M, Emberson, J, Jafar, TH, Jee, SH, Polkinghorne, KR, Shankar, A, Smith, DH, Tonelli, M, Warnock, DG, Wen, CP, Coresh, J, Gansevoort, RT, Hemmelgarn, B & Levey, AS 2012, 'Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate', JAMA, vol. 307, no. 18, pp. 1941 - 1951. https://doi.org/10.1001/jama.2012.3954

Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate. / Matsushita, Kunihiro; Mahmoodi, Bakhtawar K; Woodward, Mark; Emberson, Jonathan; Jafar, Tazeen H; Jee, Sun Ha; Polkinghorne, Kevan R; Shankar, Anoop; Smith, David H; Tonelli, Marcello; Warnock, David G; Wen, Chi Pang; Coresh, Josef; Gansevoort, Ron T; Hemmelgarn, Brenda; Levey, Andrew S.

In: JAMA, Vol. 307, No. 18, 2012, p. 1941 - 1951.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate

AU - Matsushita, Kunihiro

AU - Mahmoodi, Bakhtawar K

AU - Woodward, Mark

AU - Emberson, Jonathan

AU - Jafar, Tazeen H

AU - Jee, Sun Ha

AU - Polkinghorne, Kevan R

AU - Shankar, Anoop

AU - Smith, David H

AU - Tonelli, Marcello

AU - Warnock, David G

AU - Wen, Chi Pang

AU - Coresh, Josef

AU - Gansevoort, Ron T

AU - Hemmelgarn, Brenda

AU - Levey, Andrew S

PY - 2012

Y1 - 2012

N2 - CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk implications in diverse settings is lacking. OBJECTIVE: To evaluate risk implications of estimated GFR using the CKD-EPI equation compared with the MDRD Study equation in populations with a broad range of demographic and clinical characteristics. DESIGN, SETTING, AND PARTICIPANTS: A meta-analysis of data from 1.1 million adults (aged >/= 18 years) from 25 general population cohorts, 7 high-risk cohorts (of vascular disease), and 13 CKD cohorts. Data transfer and analyses were conducted between March 2011 and March 2012. MAIN OUTCOME MEASURES: All-cause mortality (84,482 deaths from 40 cohorts), cardiovascular mortality (22,176 events from 28 cohorts), and end-stage renal disease (ESRD) (7644 events from 21 cohorts) during 9.4 million person-years of follow-up; the median of mean follow-up time across cohorts was 7.4 years (interquartile range, 4.2-10.5 years). RESULTS: Estimated GFR was classified into 6 categories (>/=90, 60-89, 45-59, 30-44, 15-29, and /=65 years), sex, race/ethnicity (white, Asian, and black), and presence or absence of diabetes and hypertension. The results in the high-risk and CKD cohorts were largely consistent with the general population cohorts. CONCLUSION: The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and ESRD than did the MDRD Study equation across a broad range of populations.

AB - CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk implications in diverse settings is lacking. OBJECTIVE: To evaluate risk implications of estimated GFR using the CKD-EPI equation compared with the MDRD Study equation in populations with a broad range of demographic and clinical characteristics. DESIGN, SETTING, AND PARTICIPANTS: A meta-analysis of data from 1.1 million adults (aged >/= 18 years) from 25 general population cohorts, 7 high-risk cohorts (of vascular disease), and 13 CKD cohorts. Data transfer and analyses were conducted between March 2011 and March 2012. MAIN OUTCOME MEASURES: All-cause mortality (84,482 deaths from 40 cohorts), cardiovascular mortality (22,176 events from 28 cohorts), and end-stage renal disease (ESRD) (7644 events from 21 cohorts) during 9.4 million person-years of follow-up; the median of mean follow-up time across cohorts was 7.4 years (interquartile range, 4.2-10.5 years). RESULTS: Estimated GFR was classified into 6 categories (>/=90, 60-89, 45-59, 30-44, 15-29, and /=65 years), sex, race/ethnicity (white, Asian, and black), and presence or absence of diabetes and hypertension. The results in the high-risk and CKD cohorts were largely consistent with the general population cohorts. CONCLUSION: The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and ESRD than did the MDRD Study equation across a broad range of populations.

UR - http://www.ncbi.nlm.nih.gov/pubmed/22570462

U2 - 10.1001/jama.2012.3954

DO - 10.1001/jama.2012.3954

M3 - Article

VL - 307

SP - 1941

EP - 1951

JO - JAMA

JF - JAMA

SN - 0098-7484

IS - 18

ER -