title: Estimation of glomerular filtration rate by MDRD-4 IDMS and CKD-EPI in individuals of 60 years of age or older in primary care.
abstract: OBJECTIVE
  To compare the prevalence and classification of chronic kidney disease (CKD) in accordance with the estimated glomerular filtration rate (eGFR) by MDRD-4 IDMS and CKD-EPI in individuals ≥ 60 years of age in primary care.
  
  
  METHODS
  Cross-sectional descriptive observational study. Subjects ≥ 60 years treated at 40 primary care centres with serum creatinine determination conducted between 1 January and 31 December 2010 at a single centralised laboratory.
  
  
  METHODS
  renal transplantation, home care.
  
  
  METHODS
  socio-demographic, anthropometric, risk factors and cardiovascular disease as recorded in electronic medical records and serum creatinine concentration by a standardised compensated kinetic Jaffe method with IDMS and eGFR by MDRD-4 IDMS and CKD-EPI. Agreement was analysed using the kappa coefficient and the Bland-Altman graphical method.
  
  
  RESULTS
  97,554 individuals (57.3% women, mean age 70.0 [Q1: 65.0, Q3: 77.0]). Median eGFR with MDRD 78.7 [66.7, 91.0] ml/min/1.73m² (77.9 for women, 79.7 for men, P<.001) and 81.8 [68.5, 90.5] ml/min/1.73 m² (P=.311) with CKD-EPI, eFG(MDRD) prevalence <60 15.0% (16.5% women, 13.1% men and 6.5% in ≤ 70 years, 24%> 70 years) with CKD-EPI 14.2% (15.0% female, 13.0% male, 4.7% in ≤ 70 years, 24.1% in> 70 years) . There was an overall agreement of 85.6% (kappa coefficient = 0.75) in women> 70 years of 86.6% (kappa = 0.77), of 83.2% (kappa = 0.69) in men> 70 years, of 82.7% (kappa = 0.68) in women ≤ 70 years and 90% (kappa = 0.81) in men ≤ 70 years.
  
  
  CONCLUSIONS
  CKD-EPI decreased the prevalence of CKD especially in women ≤ 70 years; the prevalence increased in men> 70 years. One in eight individuals with stage 3a was reclassified to no disease; reclassified individuals had lower comorbidity.
authors.affiliation: Equipo de Atención Primaria Florida Sud, SAP Delta Llobregat, DAP Costa de Ponent, Grupo MACAP IDIAP Jordi Gol, L'Hospitalet de Llobregat, Barcelona, Spain. bsalvador@ambitcp.catsalut.net
authors.forename: Betlem
authors.initials: B
authors.lastname: Salvador-González
authors.forename: Luisa M
authors.initials: LM
authors.lastname: Rodríguez-Latre
authors.forename: Roser
authors.initials: R
authors.lastname: Güell-Miró
authors.forename: Virtudes
authors.initials: V
authors.lastname: Álvarez-Funes
authors.forename: Héctor
authors.initials: H
authors.lastname: Sanz-Ródenas
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Tovillas-Morán
mesh_terms: D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000503:physiopathology