Comparison of the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations

Prevalence of and risk factors for diabetes mellitus in CKD in the Kidney Early Evaluation Program (KEEP)

Samy I. McFarlane, Peter A. McCullough, James R. Sowers, Kyaw Soe, Shu Cheng Chen, Suying Li, Joseph A. Vassalotti, Lesley A. Stevens, Moro O. Salifu, Manjula Kurella Tamura, Andrew S. Bomback, Keith C. Norris, Allan J. Collins, George L. Bakris, Adam T. Whaley-Connell

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalAmerican Journal of Kidney Diseases
Volume57
Issue number3 SUPPL. 2
DOIs
StatePublished - Mar 1 2011

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Diet Therapy
Program Evaluation
Chronic Renal Insufficiency
Diabetes Mellitus
Epidemiology
Cross-Sectional Studies
Kidney
Kidney Diseases
Hypertension
Glomerular Filtration Rate
Logistic Models
Dyslipidemias
African Americans
Population
Body Mass Index
Cardiovascular Diseases
Obesity
Demography

Keywords

  • Chronic kidney disease
  • diabetes mellitus
  • estimated glomerular filtration rate

ASJC Scopus subject areas

  • Nephrology

Cite this

Comparison of the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations : Prevalence of and risk factors for diabetes mellitus in CKD in the Kidney Early Evaluation Program (KEEP). / McFarlane, Samy I.; McCullough, Peter A.; Sowers, James R.; Soe, Kyaw; Chen, Shu Cheng; Li, Suying; Vassalotti, Joseph A.; Stevens, Lesley A.; Salifu, Moro O.; Kurella Tamura, Manjula; Bomback, Andrew S.; Norris, Keith C.; Collins, Allan J.; Bakris, George L.; Whaley-Connell, Adam T.

In: American Journal of Kidney Diseases, Vol. 57, No. 3 SUPPL. 2, 01.03.2011.

Research output: Contribution to journalArticle

McFarlane, SI, McCullough, PA, Sowers, JR, Soe, K, Chen, SC, Li, S, Vassalotti, JA, Stevens, LA, Salifu, MO, Kurella Tamura, M, Bomback, AS, Norris, KC, Collins, AJ, Bakris, GL & Whaley-Connell, AT 2011, 'Comparison of the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations: Prevalence of and risk factors for diabetes mellitus in CKD in the Kidney Early Evaluation Program (KEEP)', American Journal of Kidney Diseases, vol. 57, no. 3 SUPPL. 2. https://doi.org/10.1053/j.ajkd.2010.11.009
McFarlane, Samy I. ; McCullough, Peter A. ; Sowers, James R. ; Soe, Kyaw ; Chen, Shu Cheng ; Li, Suying ; Vassalotti, Joseph A. ; Stevens, Lesley A. ; Salifu, Moro O. ; Kurella Tamura, Manjula ; Bomback, Andrew S. ; Norris, Keith C. ; Collins, Allan J. ; Bakris, George L. ; Whaley-Connell, Adam T. / Comparison of the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) study equations : Prevalence of and risk factors for diabetes mellitus in CKD in the Kidney Early Evaluation Program (KEEP). In: American Journal of Kidney Diseases. 2011 ; Vol. 57, No. 3 SUPPL. 2.
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abstract = "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.",
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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.

PY - 2011/3/1

Y1 - 2011/3/1

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

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DO - 10.1053/j.ajkd.2010.11.009

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JO - American Journal of Kidney Diseases

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