title: Comparison of predictive performance of renal function estimation equations for all-cause and cardiovascular mortality in an elderly hypertensive population.
abstract: BACKGROUND
  The Modifications of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) are 2 equations commonly used to estimate glomerular filtration rate (eGFR). The predictive performance offered by these equations, particularly in relation to clinical outcomes in elderly hypertensive patients, is not clear.
  
  
  METHODS
  The Second Australian National Blood Pressure Study cohort was used to investigate the predictive performance of these 2 equations for long-term outcomes (median 10.8 years) in elderly treated hypertensive patients. Both equations were used to calculate eGFR in 6,083 patients aged ≥65 years and classified as having chronic kidney disease (CKD) or no CKD (eGFR ≥60ml/min/1.73 m2).
  
  
  RESULTS
  More patients were classified as having no CKD using the CKD-EPI equation compared with the MDRD equation (72.1% vs. 69.4%; P = 0.001). Both equations performed similarly in risk prediction of all-cause and cardiovascular mortality with decreased eGFR, except for patients with baseline eGFR of 45-59ml/min/1.73 m2, where the CKD-EPI equation predicted higher risk of all-cause mortality compared with those with no CKD. However, the magnitude of difference in risk prediction was too small to be clinically meaningful. Both equations showed similar predictive performance. However, we observed longer survival and no higher risk in those who were reclassified as having no CKD using the CKD-EPI equation, but these patients were classified earlier as having CKD using the MDRD equation.
  
  
  CONCLUSIONS
  There was no clinically relevant difference in predictive performance for long-term survival by eGFR calculated using either of these equations in this elderly hypertensive population.
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Victoria, Australia;
authors.forename: Enayet K
authors.initials: EK
authors.lastname: Chowdhury
authors.affiliation: Department of Nephrology and University of Melbourne Department of Medicine, St. Vincent's Hospital, Melbourne, Australia;
authors.forename: Robyn G
authors.initials: RG
authors.lastname: Langham
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Victoria, Australia;
authors.forename: Alice
authors.initials: A
authors.lastname: Owen
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Victoria, Australia;
authors.forename: Henry
authors.initials: H
authors.lastname: Krum
authors.affiliation: School of Medicine, Flinders University, South Australia;
authors.forename: Lindon M H
authors.initials: LM
authors.lastname: Wing
authors.affiliation: Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Nelson
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Victoria, Australia; chris.reid@monash.edu.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Reid
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; chronic kidney disease; elderly; glomerular filtration rate; hypertension; mortality.