Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes: the eGFR Study

Maple-Brown, L. J., Ekinci, E. I., Hughes, J. T., Chatfield, M., Lawton, P. D., Jones, G. R. D., Ellis, A. G., Sinha, A., Cass, A., Hoy, W. E., O'Dea, K., Jerums, G. and Macisaac, .R. J. (2014) Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes: the eGFR Study. Diabetic Medicine, 31 7: 829-838. doi:10.1111/dme.12426


Author Maple-Brown, L. J.
Ekinci, E. I.
Hughes, J. T.
Chatfield, M.
Lawton, P. D.
Jones, G. R. D.
Ellis, A. G.
Sinha, A.
Cass, A.
Hoy, W. E.
O'Dea, K.
Jerums, G.
Macisaac, .R. J.
Title Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes: the eGFR Study
Journal name Diabetic Medicine   Check publisher's open access policy
ISSN 0742-3071
1464-5491
Publication date 2014-07
Year available 2014
Sub-type Article (original research)
DOI 10.1111/dme.12426
Open Access Status
Volume 31
Issue 7
Start page 829
End page 838
Total pages 10
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2015
Language eng
Formatted abstract
Aims It has been proposed that the Chronic Kidney Disease Epidemiology Collaboration formula estimates glomerular
filtration rate more accurately than the Modification of Diet in Renal Disease formula. With the very high incidence of
diabetes and end-stage kidney disease in Indigenous Australians, accurate estimation of glomerular filtration rate is vital
in early detection of kidney disease. We aimed to assess the performance of the Chronic Kidney Disease Epidemiology
Collaboration, Modification of Diet in Renal Disease and Cockcroft–Gault formulas in Indigenous Australians with and
without diabetes.

Methods Indigenous Australians with (n = 224) or without (n = 340) Type 2 diabetes had a reference glomerular
filtration rate measure using plasma disappearance of iohexol (measured glomerular filtration rate) over 4 h. Serum
creatinine was measured by an enzymatic method. Performance was assessed by bias (measured glomerular filtration
rate – estimated glomerular filtration rate) and accuracy (percentage of estimated glomerular filtration rate within 30%
of measured glomerular filtration rate).

Results The median measured glomerular filtration rate (interquartile range) in participants with or without diabetes
was 97 (68–119) and 108 (90–122) ml -1 1.73 -2, respectively. The Chronic Kidney Disease Epidemiology Collaboration formula had smaller bias and greater accuracy than the Modification of Diet in Renal Disease and Cockcroft–Gault formulas overall, for participants both with and without diabetes. However, for estimated glomerularfiltration rate > 90 ml -1 1.73 -2
, the Chronic Kidney Disease Epidemiology Collaboration formula had greaterbias in participants with diabetes, underestimating measured glomerular filtration rate by 7.4 vs.1.0 ml min-1 1.73 -2 in those without diabetes. The Chronic Kidney Disease Epidemiology Collaboration formula was less accurate across the whole range of estimated glomerular filtration rates in participants with vs. those without diabetes (87.1% vs. 93.3%).

Conclusions The Chronic Kidney Disease Epidemiology Collaboration formula outperforms the Modification of Diet in
Renal Disease and Cockcroft–Gault formulas overall in Indigenous Australians with and without diabetes. However, the
Chronic Kidney Disease Epidemiology Collaboration formula has greater bias in people with diabetes compared with
those without diabetes, especially in those with normal renal function.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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