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Asejeje FO, Ighodaro OM, Asejeje GI, Adeosun AM. Protective role of apple cider vinegar (APCV) in CCl 4-induced renal damage in wistar rats. Metabol Open 2020; 8:100063. [PMID: 33103102 PMCID: PMC7575871 DOI: 10.1016/j.metop.2020.100063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/11/2020] [Accepted: 09/26/2020] [Indexed: 11/25/2022] Open
Abstract
Background Apple Cider Vinegar, (APCV) has been locally associated with a number of health benefits, including protection against oxidative stress and related ailments. It is on this background the present study assessed its protective effects against carbon tetrachloride (CCl4)-induced oxidative damage in kidneys of rats. Methods Twenty four adult rats of Wistar strain were randomly assigned to four groups (n = 6). While group I animals served as control; kidney oxidative damage was induced in groups II and III animals using a single intraperitoneal injection of CCl4 (100%, 1.73 mL/kg body weight, BW). Group II animals were left untreated and groups III and IV counterparts were administered APCV (1.56 mL/kg BW) once daily for a period of 7 days. Thereafter, the animals were fasted over night, and sacrificed by cervical dislocation, and samples (blood and kidney tissues) were collected for biochemical/histopathological examinations. Kidney function markers including urea, creatinine, sodium ion (Na+) and potassium ion (k+) were determined in the serum while thin sections of kidneys were processed for histopathological screening. Results Compared to the control animals, CCl4 administration caused kidney damage as evidenced by significant (P < 0.05) increase in the evaluated indices (urea, creatinine, Na+ and K+). Interestingly, treatment of CCl4-exposed rats with APCV markedly reversed the above alterations to near normal. Besides, APCV treatment ameliorated the histological derangements (hemorrhagic lesions) caused by CCl4 in the kidney of the experimental rats. Conclusion These observations apparently suggest that Apple cider vinegar has the therapeutic potential to protect against renal impairment and attendant malfunction.
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Affiliation(s)
- F O Asejeje
- Department of Biochemistry, Koladaisi University, Ibadan, Nigeria
| | - O M Ighodaro
- Department of Biochemistry, Lead City University, Ibadan, Nigeria
| | - G I Asejeje
- Department of Chemistry, University of Ibadan, Nigeria
| | - A M Adeosun
- Department of Biochemistry, Lead City University, Ibadan, Nigeria
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Xie P, Li HL, Huang JM, Wei LG. Validation of the full-age spectrum equation in the approximation of glomerular filtration rate in Chinese patients with chronic kidney disease. Ren Fail 2020; 41:467-472. [PMID: 31162994 PMCID: PMC6571547 DOI: 10.1080/0886022x.2019.1620773] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Introduction: To investigate the validity of the full age spectrum (FAS) equation in determining the glomerular filtration rate (GFR) in Chinese patients with chronic kidney disease (CKD) and to compare the performance of FAS equation and the technetium-99m-diethylene triamine pentaacetic acid (Tc-99m-DTPA) renal dynamic imaging method. Methods: The GFR was determined by three methods in the same day: (a) Tc-99m-DTPA dual plasma sample clearance method (mGFR); (b) FAS equation (eGFR1); (c) Tc-99m-DTPA renal dynamic imaging method (eGFR2). The mGFR was used as the reference standard. The Bland-Altman method, concordance correlation coefficient and regression equation were applied to evaluate the validity of the estimated glomerular filtration rate (eGFR). The bias, precision and accuracy were analyzed to compare the performances of eGFR1 and eGFR2. Results: A total of 162 subjects were enrolled in this study. The eGFR1 was correlated well with mGFR (concordance correlation coefficient was 0.896, p < 0.0001) and the regression equation was mGFR = -0.374 + 1.029eGFR1 (p < 0001). The Bland-Altman analysis proved good agreement between the eGFR1 and mGFR. In comparison with eGFR2, the eGFR1 showed better performance on bias (-1.22 vs. 8.92, p < 0001), precision (15.69 vs. 18.36, p = 0.047) and 30% accuracy (75.31% vs. 59.26%, p = 0.0009) in all participants. Conclusions: The FAS equation is valid in determining the glomerular filtration rate in Chinese patients with chronic kidney disease. The Tc-99m-DTPA renal dynamic imaging method is less accurate than the FAS equation and cannot be employed as the reference method in assessing the performance of FAS equation.
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Affiliation(s)
- Peng Xie
- a Department of Nuclear Medicine , The Third Hospital, Hebei Medical University , Hebei , People's Republic of China
| | - Huan-Li Li
- b Department of Ophthalmology , The Hebei General Hospital , Hebei , People's Republic of China
| | - Jian-Min Huang
- a Department of Nuclear Medicine , The Third Hospital, Hebei Medical University , Hebei , People's Republic of China
| | - Ling-Ge Wei
- a Department of Nuclear Medicine , The Third Hospital, Hebei Medical University , Hebei , People's Republic of China
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Asmamaw T, Genet S, Menon M, Tarekegn G, Chekol E, Geto Z, Lejisa T, Habtu W, Getahun T, Tolcha Y. Early Detection of Renal Impairment Among Patients with Type 2 Diabetes Mellitus Through Evaluation of Serum Cystatin C in Comparison with Serum Creatinine Levels: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:4727-4735. [PMID: 33299336 PMCID: PMC7721116 DOI: 10.2147/dmso.s279949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The proportion of patients with end-stage renal disease caused by diabetes has progressively increased during the last few decades. Serum creatinine level is the most commonly used biochemical parameter to estimate GFR in routine practice. However, 50% of GFR can be lost before significant elevation of serum creatinine. Cystatin C is found to be a new promising marker for early detection of renal diseases. OBJECTIVE OF THE STUDY The aim of this study was to determine the value of serum cystatin C and serum creatinine levels for early detection of renal disease in patients with type 2 diabetes mellitus. METHODOLOGY A hospital-based comparative cross-sectional study was conducted with a sample size of 120. For early detection of renal disease in patients with type 2 diabetes mellitus, serum creatinine and cystatin C levels were measured and compared. RESULT AND DISCUSSION Serum creatinine and cystatin C levels were significantly increased in patients with type 2 diabetes mellitus compared to healthy controls. The mean±SD value of serum creatinine was found to be 0.87±0.44 mg/dL in patients and 0.63±0.27 mg/dL in control. Serum cystatin C level was also found to be significantly (P=0.0001) higher in patients (0.92±0.38 mg/L) compared to controls (0.52±0.20 mg/L). The mean±SD of eGFR in three equations (Creatinine Equation, Cystatin C Equation, and Creatinine-Cystatin C Equation) were 105.7±27.5 mL/min/m2, 90.4±28.2 mL/min/m2, and 100±29.5 mL/min/m2, respectively. CONCLUSION Cystatin C-based GFR estimation equations detect renal impairment in patients with type 2 diabetes mellitus earlier than creatinine-based GFR estimation equations.
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Affiliation(s)
- Tadesse Asmamaw
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Tadesse Asmamaw Email
| | - Solomon Genet
- Department of Biochemistry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Menakath Menon
- Department of Biochemistry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getahun Tarekegn
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Endeshaw Chekol
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Zeleke Geto
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tadesse Lejisa
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wossene Habtu
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tigist Getahun
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yosef Tolcha
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Legrand H, Werner K, Christensson A, Pihlsgård M, Elmståhl S. Prevalence and determinants of differences in cystatin C and creatinine-based estimated glomerular filtration rate in community-dwelling older adults: a cross-sectional study. BMC Nephrol 2017; 18:350. [PMID: 29202804 PMCID: PMC5716370 DOI: 10.1186/s12882-017-0759-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/16/2017] [Indexed: 12/13/2022] Open
Abstract
Background Differences in cystatin C and creatinine-based estimated glomerular filtration rate (eGFR) can lead to clinical uncertainty. Existing eGFR equations perform poorly in a subset of individuals. This study aims to describe the prevalence of differences between cystatin C-based (eGFRcys) and creatinine-based (eGFRcreat) eGFR in older adults and to explore which subsets of individuals may be most affected by differing estimations. Methods In this cross-sectional study, participants from a cohort of community-dwelling older adults were examined at a baseline visit in 2001-2004 as part of the larger “Good Aging in Skåne” study. Exposure variables were obtained from questionnaires, interviews, examinations, and medical records. Blood samples were taken during the baseline visit, cryopreserved, and analyzed at a later time for biomarkers. The CKD-EPI equations were used to estimate GFR. Initial descriptive analyses were performed on 2931 individuals. A total of 2532 participants were included in the final multiple linear regression. Results Nearly two-thirds of participants had eGFR differences exceeding 10%, with nearly 20 % of participants having eGFR differences exceeding 30%. Smoking, age, body mass index (BMI), C-reactive protein (CRP), glucocorticoid use, and mean eGFR were correlated with differences between eGFRcreat and eGFRcys. Conclusions Differences between eGFRcreat and eGFRcys are common and often of large magnitude in this community-dwelling population of older adults. The finding of multiple non-GFR determinants correlated to differences in GFR estimations can help direct future research to improve eGFR equations for subgroups prone to conflicting GFR estimations or to guide choice of biomarker for GFR estimation in these subgroups. Electronic supplementary material The online version of this article (10.1186/s12882-017-0759-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helen Legrand
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, 20502, Malmö, Sweden.
| | - Karin Werner
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, 20502, Malmö, Sweden.,Department of Geriatrics, Skåne University Hospital, Malmö, Sweden
| | - Anders Christensson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Department of Nephrology, Skåne University Hospital, Malmö, Sweden.,, Jan Waldenströms gata 15, plan 5, 205 02, Malmö, Sweden
| | - Mats Pihlsgård
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, 20502, Malmö, Sweden.,Department of Geriatrics, Skåne University Hospital, Malmö, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, 20502, Malmö, Sweden.,Department of Geriatrics, Skåne University Hospital, Malmö, Sweden
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Alaini A, Malhotra D, Rondon-Berrios H, Argyropoulos CP, Khitan ZJ, Raj DSC, Rohrscheib M, Shapiro JI, Tzamaloukas AH. Establishing the presence or absence of chronic kidney disease: Uses and limitations of formulas estimating the glomerular filtration rate. World J Methodol 2017; 7:73-92. [PMID: 29026688 PMCID: PMC5618145 DOI: 10.5662/wjm.v7.i3.73] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/17/2017] [Accepted: 05/30/2017] [Indexed: 02/06/2023] Open
Abstract
The development of formulas estimating glomerular filtration rate (eGFR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity, gender and age, has led to the current scheme of diagnosing and staging chronic kidney disease (CKD), which is based on eGFR values and albuminuria. This scheme has been applied extensively in various populations and has led to the current estimates of prevalence of CKD. In addition, this scheme is applied in clinical studies evaluating the risks of CKD and the efficacy of various interventions directed towards improving its course. Disagreements between creatinine-based and cystatin-based eGFR values and between eGFR values and measured GFR have been reported in various cohorts. These disagreements are the consequence of variations in the rate of production and in factors, other than GFR, affecting the rate of removal of creatinine and cystatin C. The disagreements create limitations for all eGFR formulas developed so far. The main limitations are low sensitivity in detecting early CKD in several subjects, e.g., those with hyperfiltration, and poor prediction of the course of CKD. Research efforts in CKD are currently directed towards identification of biomarkers that are better indices of GFR than the current biomarkers and, particularly, biomarkers of early renal tissue injury.
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Affiliation(s)
- Ahmed Alaini
- Division of Nephrology, Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Deepak Malhotra
- Division of Nephrology, Department of Medicine, University of Toledo School of Medicine, Toledo, OH 43614-5809, United States
| | - Helbert Rondon-Berrios
- Renal and Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15260, United States
| | - Christos P Argyropoulos
- Division of Nephrology, Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Zeid J Khitan
- Division of Nephrology, Department of Medicine, Joan C. Edwards School of Medicine, Huntington, WV 25701, United States
| | - Dominic S C Raj
- Division of Nephrology, Department of Medicine, George Washington University, Washington, DC 20037, United States
| | - Mark Rohrscheib
- Division of Nephrology, Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, United States
| | - Joseph I Shapiro
- Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, United States
| | - Antonios H Tzamaloukas
- Nephrology Section, Medicine Service, Raymond G. Murphy VA Medical Center, Albuquerque, NM 87108, United States
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87108, United States
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Ji M, Lee YH, Hur M, Kim H, Cho HI, Yang HS, Navarin S, Di Somma S. Comparing Results of Five Glomerular Filtration Rate-Estimating Equations in the Korean General Population: MDRD Study, Revised Lund-Malmö, and Three CKD-EPI Equations. Ann Lab Med 2017; 36:521-8. [PMID: 27578504 PMCID: PMC5011104 DOI: 10.3343/alm.2016.36.6.521] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/24/2016] [Accepted: 07/20/2016] [Indexed: 11/19/2022] Open
Abstract
Background Estimated glomerular filtration rate (eGFR) is a widely used index of kidney function. Recently, new formulas such as the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations or the Lund-Malmö equation were introduced for assessing eGFR. We compared them with the Modification of Diet in Renal Disease (MDRD) Study equation in the Korean adult population. Methods The study population comprised 1,482 individuals (median age 51 [42-59] yr, 48.9% males) who received annual physical check-ups during the year 2014. Serum creatinine (Cr) and cystatin C (CysC) were measured. We conducted a retrospective analysis using five GFR estimating equations (MDRD Study, revised Lund-Malmö, and Cr and/or CysC-based CKD-EPI equations). Reduced GFR was defined as eGFR <60 mL/min/1.73 m2. Results For the GFR category distribution, large discrepancies were observed depending on the equation used; category G1 (≥90 mL/min/1.73 m2) ranged from 7.4-81.8%. Compared with the MDRD Study equation, the other four equations overestimated GFR, and CysC-based equations showed a greater difference (-31.3 for CKD-EPICysC and -20.5 for CKD-EPICr-CysC). CysC-based equations decreased the prevalence of reduced GFR by one third (9.4% in the MDRD Study and 2.4% in CKD-EPICysC). Conclusions Our data shows that there are remarkable differences in eGFR assessment in the Korean population depending on the equation used, especially in normal or mildly decreased categories. Further prospective studies are necessary in various clinical settings.
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Affiliation(s)
- Misuk Ji
- Department of Laboratory Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Yoon Hee Lee
- Korea Association of Health Promotion, Seoul, Korea
| | - Mina Hur
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea.
| | - Hyesun Kim
- Korea Association of Health Promotion, Seoul, Korea
| | - Han Ik Cho
- Korea Association of Health Promotion, Seoul, Korea
| | - Hyun Suk Yang
- Department of Cardiovascular Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Silvia Navarin
- Department of Medical Sciences and Translational Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Salvatore Di Somma
- Department of Medical Sciences and Translational Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
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Abstract
Chronic kidney disease (CKD) is currently defined by abnormalities of kidney structure or function assessed using a matrix of variables - including glomerular filtration rate (GFR), thresholds of albuminuria and duration of injury - and is considered by many to be a common disorder globally. However, estimates of CKD prevalence vary widely, both within and between countries. The reasons for these variations are manifold, and include true regional differences in CKD prevalence, vagaries of using estimated GFR (eGFR) for identifying CKD, issues relating to the use of set GFR thresholds to define CKD in elderly populations, and concerns regarding the use of one-off testing for assessment of eGFR or albuminuria to define the prevalence of CKD in large-scale epidemiological studies. Although CKD is common, the suggestion that its prevalence is increasing in many countries might not be correct. Here, we discuss the possible origins of differences in estimates of CKD prevalence, and present possible solutions for tackling the factors responsible for the reported variations in GFR measurements. The strategies we discuss include approaches to improve testing methodologies for more accurate assessment of GFR, to improve awareness of factors that can alter GFR readouts, and to more accurately stage CKD in certain populations, including the elderly.
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Wang J, Xie P, Huang JM, Qu Y, Zhang F, Wei LG, Fu P, Huang XJ. The new Asian modified CKD-EPI equation leads to more accurate GFR estimation in Chinese patients with CKD. Int Urol Nephrol 2016. [PMID: 27488612 DOI: 10.1007/s11255-16-1386-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To verify whether the new Asian modified CKD-EPI equation improved the performance of original one in determining GFR in Chinese patients with CKD. METHOD A well-designed paired cohort was set up. Measured GFR (mGFR) was the result of 99mTc-diethylene triamine pentaacetic acid (99mTc-DTPA) dual plasma sample clearance method. The estimated GFR (eGFR) was the result of the CKD-EPI equation (eGFR1) and the new Asian modified CKD-EPI equation (eGFR2). The comparisons were performed to evaluate the superiority of the eGFR2 in bias, accuracy, precision, concordance correlation coefficient and the slope of regression equation and measure agreement. RESULTS A total of 195 patients were enrolled and analyzed. The new Asian modified CKD-EPI equation improved the performance of the original one in bias and accuracy. However, nearly identical performance was observed in the respect of precision, concordance correlation coefficient, slope of eGFR against mGFR and 95 % limit of agreement. In the subgroup of GFR < 60 mL min-1/1.73 m2, the bias of eGFR1 was less than eGFR2 but they have comparable precision and accuracy. In the subgroup of GFR > 60 mL min-1/1.73 m2, eGFR2 performed better than eGFR1 in terms of bias and accuracy. CONCLUSION The new Asian modified CKD-EPI equation can lead to more accurate GFR estimation in Chinese patients with CKD in general practice, especially in the higher GFR group.
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Affiliation(s)
- Jinghua Wang
- Department of Nephrology, Bethune International Peace Hospital, No. 398 of Zhongshan Western Road, Shijiazhuang, Hebei Province, People's Republic of China
| | - Peng Xie
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China.
| | - Jian-Min Huang
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Yan Qu
- Department of Research, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Fang Zhang
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Ling-Ge Wei
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Peng Fu
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Xiao-Jie Huang
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
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Wang J, Xie P, Huang JM, Qu Y, Zhang F, Wei LG, Fu P, Huang XJ. The new Asian modified CKD-EPI equation leads to more accurate GFR estimation in Chinese patients with CKD. Int Urol Nephrol 2016; 48:2077-2081. [PMID: 27488612 DOI: 10.1007/s11255-016-1386-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 07/26/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To verify whether the new Asian modified CKD-EPI equation improved the performance of original one in determining GFR in Chinese patients with CKD. METHOD A well-designed paired cohort was set up. Measured GFR (mGFR) was the result of 99mTc-diethylene triamine pentaacetic acid (99mTc-DTPA) dual plasma sample clearance method. The estimated GFR (eGFR) was the result of the CKD-EPI equation (eGFR1) and the new Asian modified CKD-EPI equation (eGFR2). The comparisons were performed to evaluate the superiority of the eGFR2 in bias, accuracy, precision, concordance correlation coefficient and the slope of regression equation and measure agreement. RESULTS A total of 195 patients were enrolled and analyzed. The new Asian modified CKD-EPI equation improved the performance of the original one in bias and accuracy. However, nearly identical performance was observed in the respect of precision, concordance correlation coefficient, slope of eGFR against mGFR and 95 % limit of agreement. In the subgroup of GFR < 60 mL min-1/1.73 m2, the bias of eGFR1 was less than eGFR2 but they have comparable precision and accuracy. In the subgroup of GFR > 60 mL min-1/1.73 m2, eGFR2 performed better than eGFR1 in terms of bias and accuracy. CONCLUSION The new Asian modified CKD-EPI equation can lead to more accurate GFR estimation in Chinese patients with CKD in general practice, especially in the higher GFR group.
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Affiliation(s)
- Jinghua Wang
- Department of Nephrology, Bethune International Peace Hospital, No. 398 of Zhongshan Western Road, Shijiazhuang, Hebei Province, People's Republic of China
| | - Peng Xie
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China.
| | - Jian-Min Huang
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Yan Qu
- Department of Research, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Fang Zhang
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Ling-Ge Wei
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Peng Fu
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Xiao-Jie Huang
- Institute of Nuclear Medicine, The Third Hospital, Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, People's Republic of China
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The modified CKD-EPI equation may be not more accurate than CKD-EPI equation in determining glomerular filtration rate in Chinese patients with chronic kidney disease. J Nephrol 2016; 30:397-402. [DOI: 10.1007/s40620-016-0307-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 03/29/2016] [Indexed: 10/22/2022]
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