title: Estimating glomerular filtration rates in elderly Chinese patients with chronic kidney disease: performance of six modified formulae developed in Asian populations.
abstract: OBJECTIVE
  The aim of the present study was to evaluate modified glomerular filtration rate (GFR) prediction formulae in an elderly Chinese population with chronic kidney disease (CKD).
  
  
  METHODS
  A total of 378 elderly Chinese patients with CKD were enrolled. The GFR was estimated with six modified GFR prediction formulae. The performances of the estimated GFRs were compared with those of the standard GFRs measured by technetium-99m diethyl-enetraminepentaacetic acid.
  
  
  RESULTS
  Biases were similar for Chinese formula 1, the Asian formula, and Chinese formula 2 (median difference, 2.22 mL/min/1.73 m(2) and 2.59 mL/min/1.73 m(2) for Chinese formula 1 and the Asian formula, respectively, versus (vs) 3.69 mL/min/1.73 m(2) for Chinese formula 2 [P = 0.298 and P = 0.913, respectively]). Precision was improved with the Japanese formula (interquartile range of the difference, 3.14 mL/min/1.73 m(2) of the Japanese formula versus 15.53-23.06 mL/min/1.73 m(2) of the other formulae). The accuracy of Chinese formula 2 was the highest (30% accuracy, 59.3% vs range 37.8-54.0% [P < 0.05 for all comparisons]). However, none of the modified formulae surpassed the acceptable tolerance (>70%), and the GFR category misclassification rates for all the formulae exceeded 50%.
  
  
  CONCLUSIONS
  Our findings suggest that all six modified formulae developed in Asian populations may show great bias in elderly Chinese patients with CKD. Also, our study suggests the need for uniform measures for the assessment of CKD in the elderly to guarantee better sensitivity and specificity.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, College of Biology Engineering, South China University of Technology.
authors.forename: Xun
authors.initials: X
authors.lastname: Liu
authors.forename: Haixia
authors.initials: H
authors.lastname: Xu
authors.forename: Zebin
authors.initials: Z
authors.lastname: Zheng
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Cailian
authors.initials: C
authors.lastname: Cheng
authors.forename: Chenggang
authors.initials: C
authors.lastname: Shi
authors.forename: Yihong
authors.initials: Y
authors.lastname: Gong
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Tanqi
authors.initials: T
authors.lastname: Lou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D011877:Radionuclide Imaging; D018709:Statistics, Nonparametric
keywords: Asian; CKD; GFR; formula
references.citation: Scand J Urol Nephrol. 1986;20(1):57-62
references.pmid: 3085214
references.citation: J Korean Med Sci. 2010 Nov;25(11):1616-25
references.pmid: 21060751
references.citation: Am J Kidney Dis. 2011 Dec;58(6):1043-5
references.pmid: 21995969
references.citation: Nephrol Dial Transplant. 2006 Sep;21(9):2439-45
references.pmid: 16720592
references.citation: Lancet. 2012 Jan 14;379(9811):165-80
references.pmid: 21840587
references.citation: Clin Nephrol. 2011 Oct;76(4):296-305
references.pmid: 21955865
references.citation: Kidney Int. 2011 Jul;80(1):17-28
references.pmid: 21150873
references.citation: J Am Soc Nephrol. 2006 Oct;17(10):2937-44
references.pmid: 16988059
references.citation: J Am Med Dir Assoc. 2011 May;12(4):249-56
references.pmid: 21527165
references.citation: Nephrol Dial Transplant. 2011 Sep;26(9):2780-5
references.pmid: 21357214
references.citation: Am J Kidney Dis. 2010 Jul;56(1):39-49
references.pmid: 20537455
references.citation: Aust Fam Physician. 2012 Dec;41(12):940-4
references.pmid: 23210116
references.citation: Ann Intern Med. 2012 Jun 5;156(11):785-95, W-270, W-271, W-272, W-273, W-274, W-275, W-276, W-277,
references.pmid: 22312131
references.citation: Am J Kidney Dis. 2009 Jun;53(6):932-5
references.pmid: 19463761
references.citation: Am J Kidney Dis. 2009 Jun;53(6):982-92
references.pmid: 19339088
references.citation: Arch Gerontol Geriatr. 2010 Jul-Aug;51(1):13-20
references.pmid: 19615764
references.citation: Emerg Med J. 2003 Sep;20(5):453-8
references.pmid: 12954688
references.citation: Am J Kidney Dis. 2011 Jul;58(1):56-63
references.pmid: 21601325
references.citation: Intern Med J. 2012 May;42(5):e59-67
references.pmid: 21118405