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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/3/891 |
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| author | Vincenzo Livio Malavasi Anna Chiara Valenti Sara Ruggerini Marcella Manicardi Carlotta Orlandi Daria Sgreccia Marco Vitolo Marco Proietti Gregory Y. H. Lip Giuseppe Boriani |
| author_facet | Vincenzo Livio Malavasi Anna Chiara Valenti Sara Ruggerini Marcella Manicardi Carlotta Orlandi Daria Sgreccia Marco Vitolo Marco Proietti Gregory Y. H. Lip Giuseppe Boriani |
| author_sort | Vincenzo Livio Malavasi |
| collection | DOAJ |
| 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<sup>2</sup>); G2 (eGFR 89–60 mL/min/1.73 m<sup>2</sup>); G3a (eGFR 59–45 mL/min/1.73 m<sup>2</sup>); G3b (eGFR 44–30 mL/min/1.73 m<sup>2</sup>); G4 (eGFR 29–15 mL/min/1.73 m<sup>2</sup>); G5 (eGFR <15 mL/min/1.73 m<sup>2</sup>). 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. |
| first_indexed | 2024-03-09T23:38:57Z |
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| institution | Directory Open Access Journal |
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| last_indexed | 2024-03-09T23:38:57Z |
| publishDate | 2022-02-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-6c04a0bcf8b147829f7384092dee2de02023-11-23T16:55:37ZengMDPI AGJournal of Clinical Medicine2077-03832022-02-0111389110.3390/jcm11030891Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on OutcomeVincenzo Livio Malavasi0Anna Chiara Valenti1Sara Ruggerini2Marcella Manicardi3Carlotta Orlandi4Daria Sgreccia5Marco Vitolo6Marco Proietti7Gregory Y. H. Lip8Giuseppe Boriani9Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyCardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyCardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyCardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyCardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyCardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyCardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UKLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UKCardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, ItalyBackground: 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<sup>2</sup>); G2 (eGFR 89–60 mL/min/1.73 m<sup>2</sup>); G3a (eGFR 59–45 mL/min/1.73 m<sup>2</sup>); G3b (eGFR 44–30 mL/min/1.73 m<sup>2</sup>); G4 (eGFR 29–15 mL/min/1.73 m<sup>2</sup>); G5 (eGFR <15 mL/min/1.73 m<sup>2</sup>). 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.https://www.mdpi.com/2077-0383/11/3/891chronic kidney diseaseglomerular filtration rateCKD-EPIelderlycardiovascular disease |
| spellingShingle | Vincenzo Livio Malavasi Anna Chiara Valenti Sara Ruggerini Marcella Manicardi Carlotta Orlandi Daria Sgreccia Marco Vitolo Marco Proietti Gregory Y. H. Lip Giuseppe Boriani Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome Journal of Clinical Medicine chronic kidney disease glomerular filtration rate CKD-EPI elderly cardiovascular disease |
| 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 | chronic kidney disease glomerular filtration rate CKD-EPI elderly cardiovascular disease |
| url | https://www.mdpi.com/2077-0383/11/3/891 |
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