title: [Diagnostic ability of Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease-4 equations to estimate glomerular filtration rate in with multimorbidity patients].
abstract: OBJECTIVE
  The Modification of Diet in Renal Disease (MDRD) equation is recommended by most scientific societies to calculate the estimated glomerular filtration rate (GFR). Recently the group Chronic Kidney Disease Epidemiology Collaboration (CKP-EPI) has published a new, more precise and accurate equation. We have analyzed its behavior in a group of polypathological patients (PP) and compared it with the classic MDRD-4.version
  
  
  METHODS
  Multicenter, observational, descriptive and transversal study. We calculated GFR by MDRD-4 and CKD-EPI in 425 PP. Each stage was assigned according to the GFR: 1:>90; 2: 60-89; 3: 30-59; 4: 15-29; and 5 < 15 ml/min/1.73m(2). We analyzed the correlation between both and the patients reclassified by CKD-EPI.
  
  
  RESULTS
  Mean age was (mean [SD]) 81.7 (7.9) years. 55.3% were women. The mean estimated GFR was 58.6 (26.3) ml/min/1,73m(2) by MDRD-4 and 52.7 (23.0) ml/min/1.73m(2) by CKD-EPI (P<.001; Spearman's Rho correlation and Lin concordance coefficients: 0.993 and 0.948). The Bland-Altman plots reflected lower values for GFR for CKD-EPI equation. In the stage 2, 21.2% were reclassified by CKD-EPI to the stage 3, with women older than 83 years being the more disadvantaged subgroup with 27.3% or reclassification.
  
  
  CONCLUSIONS
  CKD-EPI equation applied to PP worsens the results of MDRD-4. In general, it originates low values of GFR and increases the degree of renal insufficiency, especially in older women.
authors.affiliation: Servicio de Medicina Interna, Hospital General de la Defensa, Zaragoza, España. Electronic address: j_cabrerizo@hotmail.com.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Cabrerizo-García
authors.affiliation: Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Díez-Manglano
authors.affiliation: Servicio de Geriatría, Hospital Nuestra Señora de Gracia, Zaragoza, España.
authors.forename: Ernesto
authors.initials: E
authors.lastname: García-Arilla
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Paz
authors.initials: P
authors.lastname: Revillo-Pinilla
authors.affiliation: Servicio de Medicina Interna, Hospital General de la Defensa, Zaragoza, España.
authors.forename: José
authors.initials: J
authors.lastname: Ramón-Puertas
authors.affiliation: Servicio de Medicina Interna, Hospital General de la Defensa, Zaragoza, España.
authors.forename: Mariano
authors.initials: M
authors.lastname: Sebastián-Royo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D019338:Polypharmacy; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Comorbidity; Comorbilidad; Filtrado glomerular; Glomerular filtration rate; Insuficiencia renal; Renal insufficiency