Renal Function and Death in Older Women: Which eGFR Formula Should We Use?
Background. The Berlin Initiative Study (BIS) eGFR equations were developed specifically for aged populations, but their predictive validity compared to standard formulae is unknown in older women. Methods. In a prospective study of 1289 community-dwelling older women (mean age 79.5 years), we compa...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2017/8216878 |
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| author | Muna T. Canales Terri Blackwell Areef Ishani Brent C. Taylor Allyson Hart Rebecca J. Beyth Kristine E. Ensrud |
| author_facet | Muna T. Canales Terri Blackwell Areef Ishani Brent C. Taylor Allyson Hart Rebecca J. Beyth Kristine E. Ensrud |
| author_sort | Muna T. Canales |
| collection | DOAJ |
| description | Background. The Berlin Initiative Study (BIS) eGFR equations were developed specifically for aged populations, but their predictive validity compared to standard formulae is unknown in older women. Methods. In a prospective study of 1289 community-dwelling older women (mean age 79.5 years), we compared the performance of the BIS1 SCr-based equation to the CKD-EPIcr and the BIS2 SCr- and Scysc-based equation to the CKD-EPIcr,cysc to predict cardiovascular and all-cause mortality. Results. Prevalence of specific eGFR category (i.e., ≥75, 60–74, 45–59, and <45) according to eGFR equation was 12.3%, 38.4%, 37.3%, and 12.0% for BIS1; 48.3%, 27.8%, 16.2%, and 7.8% for CKD-EPIcr; 14.1%, 38.6%, 37.6%, and 9.6% for BIS2; and 33.5%, 33.4%, 22.0%, and 11.1% for CKD-EPIcr,cysc, respectively. Over 9±4 years, 667 (51.8%) women died. For each equation, women with eGFR <45 were at increased risk of mortality compared to eGFR ≥75 [adjusted HR (95% CI): BIS1, 1.5 (1.1–2.0); CKD-EPIcr, 1.7 (1.3–2.2); BIS2, 2.0 (1.4–2.8); CKD-EPIcr,cysc, 1.8 (1.4–2.3); p-trend <0.01]. Net reclassification analyses found no material difference in discriminant ability between the BIS and CKD-EPI equations. Results were similar for cardiovascular death. Conclusions. Compared to CKD-EPI, BIS equations identified a greater proportion of older women as having CKD but performed similarly to predict mortality risk. Thus, the BIS equations should not replace CKD-EPI equations to predict risk of death in older women. |
| format | Article |
| id | doaj-art-b2f4eedf3a40468da8c20c3ac24d9730 |
| institution | OA Journals |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-b2f4eedf3a40468da8c20c3ac24d97302025-08-20T02:23:27ZengWileyInternational Journal of Nephrology2090-214X2090-21582017-01-01201710.1155/2017/82168788216878Renal Function and Death in Older Women: Which eGFR Formula Should We Use?Muna T. Canales0Terri Blackwell1Areef Ishani2Brent C. Taylor3Allyson Hart4Rebecca J. Beyth5Kristine E. Ensrud6Malcom-Randall VAMC, Department of Medicine, University of Florida, Gainesville, FL, USAResearch Institute, California Pacific Medical Center, San Francisco, CA, USADepartment of Medicine, University of Minnesota, Minneapolis VA Health Care System, Minneapolis, MN, USACenter for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Department of Medicine, University of Minnesota, Minneapolis, MN, USAHennepin County Medical Center, Minneapolis, MN, USAMalcom-Randall VAMC GRECC, Department of Medicine, University of Florida, Gainesville, FL, USACenter for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Department of Medicine, University of Minnesota, Minneapolis, MN, USABackground. The Berlin Initiative Study (BIS) eGFR equations were developed specifically for aged populations, but their predictive validity compared to standard formulae is unknown in older women. Methods. In a prospective study of 1289 community-dwelling older women (mean age 79.5 years), we compared the performance of the BIS1 SCr-based equation to the CKD-EPIcr and the BIS2 SCr- and Scysc-based equation to the CKD-EPIcr,cysc to predict cardiovascular and all-cause mortality. Results. Prevalence of specific eGFR category (i.e., ≥75, 60–74, 45–59, and <45) according to eGFR equation was 12.3%, 38.4%, 37.3%, and 12.0% for BIS1; 48.3%, 27.8%, 16.2%, and 7.8% for CKD-EPIcr; 14.1%, 38.6%, 37.6%, and 9.6% for BIS2; and 33.5%, 33.4%, 22.0%, and 11.1% for CKD-EPIcr,cysc, respectively. Over 9±4 years, 667 (51.8%) women died. For each equation, women with eGFR <45 were at increased risk of mortality compared to eGFR ≥75 [adjusted HR (95% CI): BIS1, 1.5 (1.1–2.0); CKD-EPIcr, 1.7 (1.3–2.2); BIS2, 2.0 (1.4–2.8); CKD-EPIcr,cysc, 1.8 (1.4–2.3); p-trend <0.01]. Net reclassification analyses found no material difference in discriminant ability between the BIS and CKD-EPI equations. Results were similar for cardiovascular death. Conclusions. Compared to CKD-EPI, BIS equations identified a greater proportion of older women as having CKD but performed similarly to predict mortality risk. Thus, the BIS equations should not replace CKD-EPI equations to predict risk of death in older women.http://dx.doi.org/10.1155/2017/8216878 |
| spellingShingle | Muna T. Canales Terri Blackwell Areef Ishani Brent C. Taylor Allyson Hart Rebecca J. Beyth Kristine E. Ensrud Renal Function and Death in Older Women: Which eGFR Formula Should We Use? International Journal of Nephrology |
| title | Renal Function and Death in Older Women: Which eGFR Formula Should We Use? |
| title_full | Renal Function and Death in Older Women: Which eGFR Formula Should We Use? |
| title_fullStr | Renal Function and Death in Older Women: Which eGFR Formula Should We Use? |
| title_full_unstemmed | Renal Function and Death in Older Women: Which eGFR Formula Should We Use? |
| title_short | Renal Function and Death in Older Women: Which eGFR Formula Should We Use? |
| title_sort | renal function and death in older women which egfr formula should we use |
| url | http://dx.doi.org/10.1155/2017/8216878 |
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