The MDRD equation underestimates the prevalence of CKD among blacks and overestimates the prevalence of CKD among whites compared to the CKD-EPI equation: a retrospective cohort study

BMC Nephrology

Research Article

Nilang Patel¹  Rocco C Venuto¹  Neha Nainani¹  James W Lohr²  Pradeep Arora²  Srini Rajagopalan³ 

[1] Department of Medicine, State University of New York at Buffalo, 462 Grider Street, 14215, Buffalo, New York, USA;Department of Medicine, V.A. Medical Center, 3495 Bailey Ave., 14215, Buffalo, New York, USA;Department of Medicine, State University of New York at Buffalo, 462 Grider Street, 14215, Buffalo, New York, USA;Med Data Analytics, Inc., 5500 Main St, 14221, Williamsville, NY, USA;

关键词: Chronic Kidney Disease;    Quantile Regression;    White Individual;    Quantile Regression Model;    Serum Creatinine Measurement;   

DOI  :  10.1186/1471-2369-13-4

 received in 2011-05-23, accepted in 2012-01-20,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundBlack individuals are far more likely than white individuals to develop end stage renal disease (ESRD). However, earlier stages of chronic kidney disease (CKD) have been reported to be less prevalent among blacks. This disparity remains poorly understood. The objective of this study was to evaluate whether the lower prevalence of CKD among blacks in early stages of CKD might be due in part to an inability of the MDRD equation to accurately determine early stages of CKD in both the black and white population.MethodsWe conducted a retrospective cohort study of 97, 451 patients seen in primary care clinic in Veterans Integrated Service Network 2 (VISN 2) over a 7 year period to determine the prevalence of CKD using both the Modification of Diet in Renal Disease (MDRD) Study equation and the more recently developed CKD Epidemiology Collaboration (CKD-EPI) equation. Demographic data, comorbid conditions, prescription of medications, and laboratory data were recorded. Logistic regression and quantile regression models were used to compare the prevalence of estimated glomerular filtration rate (eGFR) categories between black and white individuals.ResultsThe overall prevalence of CKD was lower when the CKD-EPI equation was used. Prevalence of CKD in whites was 53.2% by MDRD and 48.4% by CKD-EPI, versus 34.1% by MDRD and 34.5% by CKD-EPI in blacks. The cumulative logistic regression and quantile regression showed that when eGFR was calculated by the EPI method, blacks were as likely to present with an eGFR value less than 60 mL/min/1.73 m2 as whites. Using the CKD-EPI equation, blacks were more likely than white individuals to have stage 3b, 4 and 5 CKD. Using the MDRD method, the prevalence in blacks was only higher than in whites for stage 4 and 5 CKD. Similar results were obtained when the analysis was confined to patients over 65 years of age.ConclusionsThe MDRD equation overestimates the prevalence of CKD among whites and underestimates the prevalence of CKD in blacks compared to the CKD-EPI equation.

【 授权许可】

Unknown   
© Arora et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.