Comparative performance of CKD-EPI equations in people with diabetes: An international pooled analysis of individual participant data.

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-03-15 DOI:10.1016/j.diabres.2025.112104

Rodney Kwok, Kartik Kishore, Tina Zafari, Digsu N Koye, Mariam Hachem, Ian H de Boer, Tae-Dong Jeong, Won-Ki Min, Esteban Porrini, Petter Bjornstad, Richard J MacIsaac, Leonid Churilov, Elif I Ekinci

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引用次数: 0

Abstract

Aim: This study assessed the concordance and misclassification of chronic kidney disease (CKD) stages between directly measured glomerular filtration rate (mGFR) and estimates of GFR (eGFR) using the creatinine-based CKD-EPI-2009 and the CKD-EPI-2021 equations in individuals with diabetes.

Methods: Data from 5,177 individuals across six international diabetes cohorts included mGFR measurements using exogenous filtration markers. We calculated an intra-class correlation coefficient (ICC), bias, precision and accuracy between mGFR and CKD-EPI estimates using a four-level mixed-effect linear variance component model.

Results: The pooled cohort included people with type 1 (n = 1,748, median age: 33 years [IQR: 27, 40], mGFR = 104.2 ml/min per 1.73 m²) and type 2 diabetes (n = 3,429, median age: 66 years [IQR: 58, 73], mGFR = 58.4 ml/min per 1.73 m²). Both CKD-EPI equations showed good agreement (2009 ICC: 0.90; 2021 ICC: 0.87) but substantial bias (2009: 3.7 ml/min/1.73 m²; 2021: 8.6 ml/min/1.73 m²), low precision (2009: 12.4 ml/min/1.73 m²; 2021: 13.91 ml/min/1.73 m²), and limited accuracy (2009 p30: 77 %; 2021 p30: 70 %) compared to mGFR.

Conclusion: The use of CKD-EPI equations has the potential for misdiagnosis and suboptimal CKD management in people with diabetes. Alternative methods of estimating kidney function for people with diabetes are needed to optimally manage diabetes-related kidney disease.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.