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Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome
Background: This paper aims to evaluate the concordance between the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and alternative equations and to assess their predictive power for all-cause mortality in unselected patients discharged alive from a cardiology ward. Methods: We r...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837128/ https://www.ncbi.nlm.nih.gov/pubmed/35160341 http://dx.doi.org/10.3390/jcm11030891 |
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author | Malavasi, Vincenzo Livio Valenti, Anna Chiara Ruggerini, Sara Manicardi, Marcella Orlandi, Carlotta Sgreccia, Daria Vitolo, Marco Proietti, Marco Lip, Gregory Y. H. Boriani, Giuseppe |
author_facet | Malavasi, Vincenzo Livio Valenti, Anna Chiara Ruggerini, Sara Manicardi, Marcella Orlandi, Carlotta Sgreccia, Daria Vitolo, Marco Proietti, Marco Lip, Gregory Y. H. Boriani, Giuseppe |
author_sort | Malavasi, Vincenzo Livio |
collection | PubMed |
description | Background: This paper aims to evaluate the concordance between the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and alternative equations and to assess their predictive power for all-cause mortality in unselected patients discharged alive from a cardiology ward. Methods: We retrospectively included patients admitted to our Cardiology Division independently of their diagnosis. The total population was classified according to Kidney Disease: Improving Global Outcomes (KDIGO) categories, as follows: G1 (estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m(2)); G2 (eGFR 89–60 mL/min/1.73 m(2)); G3a (eGFR 59–45 mL/min/1.73 m(2)); G3b (eGFR 44–30 mL/min/1.73 m(2)); G4 (eGFR 29–15 mL/min/1.73 m(2)); G5 (eGFR <15 mL/min/1.73 m(2)). Cockcroft-Gault (CG), CG adjusted for body surface area (CG-BSA), Modification of Diet in Renal Disease (MDRD), Berlin Initiative Study (BIS-1), and Full Age Spectrum (FAS) equations were also assessed. Results: A total of 806 patients were included. Good agreement was found between the CKD-EPI formula and CG-BSA, MDRD, BIS-1, and FAS equations. In subjects younger than 65 years or aged ≥85 years, CKD-EPI and MDRD showed the highest agreement (Cohen’s kappa (K) 0.881 and 0.588, respectively) while CG showed the lowest. After a median follow-up of 407 days, overall mortality was 8.2%. The risk of death was higher in lower eGFR classes (G3b HR4.35; 95%CI 1.05–17.80; G4 HR7.13; 95%CI 1.63–31.23; G5 HR25.91; 95%CI 6.63–101.21). The discriminant capability of death prediction tested with ROC curves showed the best results for BIS-1 and FAS equations. Conclusion: In our cohort, the concordance between CKD-EPI and other equations decreased with age, with the MDRD formula showing the best agreement in both younger and older patients. Overall, mortality rates increased with the renal function decreasing. In patients aged ≥75 years, the best discriminant capability for death prediction was found for BIS-1 and FAS equations. |
format | Online Article Text |
id | pubmed-8837128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88371282022-02-12 Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome Malavasi, Vincenzo Livio Valenti, Anna Chiara Ruggerini, Sara Manicardi, Marcella Orlandi, Carlotta Sgreccia, Daria Vitolo, Marco Proietti, Marco Lip, Gregory Y. H. Boriani, Giuseppe J Clin Med Article Background: This paper aims to evaluate the concordance between the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and alternative equations and to assess their predictive power for all-cause mortality in unselected patients discharged alive from a cardiology ward. Methods: We retrospectively included patients admitted to our Cardiology Division independently of their diagnosis. The total population was classified according to Kidney Disease: Improving Global Outcomes (KDIGO) categories, as follows: G1 (estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m(2)); G2 (eGFR 89–60 mL/min/1.73 m(2)); G3a (eGFR 59–45 mL/min/1.73 m(2)); G3b (eGFR 44–30 mL/min/1.73 m(2)); G4 (eGFR 29–15 mL/min/1.73 m(2)); G5 (eGFR <15 mL/min/1.73 m(2)). Cockcroft-Gault (CG), CG adjusted for body surface area (CG-BSA), Modification of Diet in Renal Disease (MDRD), Berlin Initiative Study (BIS-1), and Full Age Spectrum (FAS) equations were also assessed. Results: A total of 806 patients were included. Good agreement was found between the CKD-EPI formula and CG-BSA, MDRD, BIS-1, and FAS equations. In subjects younger than 65 years or aged ≥85 years, CKD-EPI and MDRD showed the highest agreement (Cohen’s kappa (K) 0.881 and 0.588, respectively) while CG showed the lowest. After a median follow-up of 407 days, overall mortality was 8.2%. The risk of death was higher in lower eGFR classes (G3b HR4.35; 95%CI 1.05–17.80; G4 HR7.13; 95%CI 1.63–31.23; G5 HR25.91; 95%CI 6.63–101.21). The discriminant capability of death prediction tested with ROC curves showed the best results for BIS-1 and FAS equations. Conclusion: In our cohort, the concordance between CKD-EPI and other equations decreased with age, with the MDRD formula showing the best agreement in both younger and older patients. Overall, mortality rates increased with the renal function decreasing. In patients aged ≥75 years, the best discriminant capability for death prediction was found for BIS-1 and FAS equations. MDPI 2022-02-08 /pmc/articles/PMC8837128/ /pubmed/35160341 http://dx.doi.org/10.3390/jcm11030891 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Malavasi, Vincenzo Livio Valenti, Anna Chiara Ruggerini, Sara Manicardi, Marcella Orlandi, Carlotta Sgreccia, Daria Vitolo, Marco Proietti, Marco Lip, Gregory Y. H. Boriani, Giuseppe Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome |
title | Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome |
title_full | Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome |
title_fullStr | Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome |
title_full_unstemmed | Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome |
title_short | Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome |
title_sort | kidney function according to different equations in patients admitted to a cardiology unit and impact on outcome |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837128/ https://www.ncbi.nlm.nih.gov/pubmed/35160341 http://dx.doi.org/10.3390/jcm11030891 |
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