Comparison of Predictability of Future Cardiovascular Events Between Chronic Kidney Disease (CKD) Stage Based on CKD Epidemiology Collaboration Equation and That Based on Modification of Diet in Renal Disease Equation in the Japanese General Population

• Ohsawa Masaki

  Department of Hygiene and Preventive Medicine, Iwate Medical University

• Tanno Kozo

  Department of Hygiene and Preventive Medicine, Iwate Medical University

• Itai Kazuyoshi

  The First Institute of Health Service, Japan Anti-Tuberculosis Association

• Turin Tanvir Chowdhury

  Department of Medicine, University of Calgary

• Okamura Tomonori

  Department of Preventive Medicine and Public Health, Keio University

• Ogawa Akira

  Department of Neurosurgery, Iwate Medical University

• Ogasawara Kuniaki

  Department of Neurosurgery, Iwate Medical University

• Fujioka Tomoaki

  Department of Urology, Iwate Medical University

• Onoda Toshiyuki

  Department of Hygiene and Preventive Medicine, Iwate Medical University

• Yoshida Yuki

  Department of Neurosurgery, Iwate Medical University

• Omama Shin-ichi

  Department of Neurosurgery, Iwate Medical University

• Ishibashi Yasuhiro

  Department of Internal Medicine, Iwate Medical University

• Nakamura Motoyuki

  Department of Internal Medicine, Iwate Medical University

• Makita Shinji

  Department of Internal Medicine, Iwate Medical University

• Tanaka Fumitaka

  Department of Internal Medicine, Iwate Medical University

• Kuribayashi Toru

  Department of Health and Physical Education, Faculty of Education, Iwate University

• Koyama Tomiko

  Iwate Health Service Association

• Sakata Kiyomi

  Department of Hygiene and Preventive Medicine, Iwate Medical University

• Okayama Akira

  The First Institute of Health Service, Japan Anti-Tuberculosis Association

Bibliographic Information

Other Title

• – Iwate KENCO Study –

Abstract

Background: Whether estimated glomerular filtration rate (eGFR) calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Study equation (eGFR_CKDEPI) improves risk prediction compared to that calculated using the Modification of Diet in Renal Disease (MDRD) study equation (eGFR_MDRD) has not been examined in a prospective study in Japanese people. Methods and Results: Participants (n=24,560) were divided into 4 stages (1, ≥90; 2, 60–89 (reference); 3a, 45–59; 3b+ <45ml·min^–1·1.73m^–2) according to eGFR_CKDEPI or eGFR_MDRD. Endpoints were all-cause death, myocardial infarction (MI) and stroke. Area under the receiver operating characteristic curves (95% confidence intervals) for predicting all-cause death, MI and stroke by eGFR_CKDEPI vs. eGFR_MDRD were 0.680 (0.662–0.697) vs. 0.582 (0.562–0.602); 0.718 (0.665–0.771) vs. 0.642 (0.581–0.703); and 0.656 (0.636–0.676) vs. 0.576 (0.553–0.599), respectively. Multivariate-adjusted Cox regression and Poisson regression analysis results were similar for adjusted incidence rates and adjusted hazard ratios in each corresponding stage between the 2 models and no differences were found in model assessment parameters. Net reclassification improvement (NRI) for predicting all-cause death, MI and stroke were estimated to be 6.7% (P<0.001), –1.89% (P=0.029) and –0.20% (P=0.421), respectively. Conclusions: Better discrimination was achieved using eGFR_CKDEPI than eGFR_MDRD on univariate analysis. NRI analysis indicated that the use of eGFR_CKDEPI instead of eGFR_MDRD offered a significant improvement in reclassification of death risk.  (Circ J 2013; 77: 1315–1325)<br>

Journal

• Circulation Journal

  Circulation Journal 77 (5), 1315-1325, 2013

  The Japanese Circulation Society

Keywords

• Chronic kidney disease
• CKD-EPI equation
• Estimated glomerular filtration rate
• MDRD equation
• Model assessment

Details

• CRID: 1390001205105504000
• NII Article ID: 10031151396
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-12-0982
• COI: 1:STN:280:DC%2BC3svgt1Wjsw%3D%3D
• ISSN: 13474820
• ISSN: 13469843
• PubMed: 23428718
• Web Site: https://www.jstage.jst.go.jp/article/circj/77/5/77_CJ-12-0982/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2014093392
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed