title: Comparison of predictive value for first cardiovascular event between Japanese GFR equation and coefficient-modified CKD-EPI equation.
abstract: BACKGROUND
  The most superior GFR-estimating equation from the viewpoint of cardiovascular disease (CVD) prediction remains unclear. Thus, we performed cross-sectional comparison between two GFR-estimating equations (Japanese GFR equation and coefficient-modified CKD-EPI equation) and CVD incidence using Japanese nationwide "specific health checkup" data.
  
  
  METHODS
  We recruited Japanese residents (241,159 individuals; mean 63 years; male, 38.6 %) who had not experienced CVD event (cardiac disease or stroke, or both). We calculated estimated GFR using two equations, and compared their predictive value for first symptomatic CVD event within 1 year.
  
  
  RESULTS
  Of all subjects, the mean GFR estimated by the Japanese GFR equation (JPN-eGFR) modified for Japanese was 75.83 ± 16.18 mL/min/1.73 m(2), and that by the coefficient-modified CKD-EPI equation (mCKDEPI-eGFR) was 76.39 ± 9.61 mL/min/1.73 m(2). Area under the receiver operating characteristics curves (95 % confidence intervals) for predicting CVD event by mCKDEPI-eGFR vs. JPN-eGFR were 0.596 (0.589-0.603) vs. 0.562 (0.554-0.569). Using mCKDEPI-eGFR, the crude odds ratio (OR) for CVD incident in the 4th quartile group was far more than double (OR 2.46, 95 % CI 2.29-2.66) that in the 1st quartile group. Using JPN-eGFR, the crude OR in the 4th quartile group was less than double (OR 1.61, 95 % CI 1.51-1.73) that in the 1st quartile group. However, such superior predictive value of mCKDEPI-eGFR disappeared after adjustment for confounding factors (age, gender, BMI, presence of proteinuria, hypertension, diabetes, dyslipidemia and current smoking).
  
  
  CONCLUSIONS
  GFR estimated by the coefficient-modified CKD-EPI equation was more closely related to CVD incidence than that estimated by the Japanese GFR equation. However, it is possible that low mCKDEPI-eGFR also reflects some cardiovascular risk(s) other than kidney dysfunction.
authors: Dialysis Center, Fukushima Medical University Hospital, 1 Hikariga-oka, Fukushima, 960-1295, Japan. terawaki@fmu.ac.jp.
authors: Hiroyuki
authors: H
authors: Terawaki
authors: Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors: Masaaki
authors: M
authors: Nakayama
authors: Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan.|Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Koichi
authors: K
authors: Asahi
authors: Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors: Takeyasu
authors: T
authors: Kakamu
authors: Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors: Takehito
authors: T
authors: Hayakawa
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Kunitoshi
authors: K
authors: Iseki
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Kenjiro
authors: K
authors: Kimura
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Toshiki
authors: T
authors: Moriyama
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Kunihiro
authors: K
authors: Yamagata
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Ichiei
authors: I
authors: Narita
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Shouichi
authors: S
authors: Fujimoto
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Kazuhiko
authors: K
authors: Tsuruya
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Tsuneo
authors: T
authors: Konta
authors: Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Masahide
authors: M
authors: Kondo
authors: iAnalysis LLC, Tokyo, Japan.
authors: Issei
authors: I
authors: Kurahashi
authors: Department of Integrated Science and Engineering for Sustainable Society, Faculty of Science and Engineering, Chuo University, Tokyo, Japan.
authors: Yasuo
authors: Y
authors: Ohashi
authors: Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors: Tetsuhito
authors: T
authors: Fukushima
authors: Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan.|Steering Committee for "Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups", Fukushima, Japan.
authors: Tsuyoshi
authors: T
authors: Watanabe
mesh_terms: D000368:Aged; D019540:Area Under Curve; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D055641:Mathematical Concepts; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve
keywords: CKD-EPI; Cardiovascular disease; Chronic kidney disease; General population; Japanese GFR equation; MDRD