Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome

Malavasi, Vincenzo Livio, Valenti, Anna Chiara, Ruggerini, Sara, Manicardi, Marcella, Orlandi, Carlotta, Sgreccia, Daria, Vitolo, Marco ORCID: 0000-0002-5196-6249, Proietti, Marco ORCID: 0000-0003-1452-2478, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Boriani, Giuseppe (2022) Kidney Function According to Different Equations in Patients Admitted to a Cardiology Unit and Impact on Outcome. JOURNAL OF CLINICAL MEDICINE, 11 (3). 891-.

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Official URL: http://dx.doi.org/10.3390/jcm11030891

Abstract

<h4>Background</h4>This paper aims to evaluate the concordance between the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula and alternative equations and to assess their predictive power for all-cause mortality in unselected patients discharged alive from a cardiology ward.<h4>Methods</h4>We retrospectively included patients admitted to our Cardiology Division independently of their diagnosis. The total population was classified according to Kidney Disease: Improving Global Outcomes (KDIGO) categories, as follows: G1 (estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m<sup>2</sup>); G2 (eGFR 89-60 mL/min/1.73 m<sup>2</sup>); G3a (eGFR 59-45 mL/min/1.73 m<sup>2</sup>); G3b (eGFR 44-30 mL/min/1.73 m<sup>2</sup>); G4 (eGFR 29-15 mL/min/1.73 m<sup>2</sup>); G5 (eGFR <15 mL/min/1.73 m<sup>2</sup>). Cockcroft-Gault (CG), CG adjusted for body surface area (CG-BSA), Modification of Diet in Renal Disease (MDRD), Berlin Initiative Study (BIS-1), and Full Age Spectrum (FAS) equations were also assessed.<h4>Results</h4>A total of 806 patients were included. Good agreement was found between the CKD-EPI formula and CG-BSA, MDRD, BIS-1, and FAS equations. In subjects younger than 65 years or aged ≥85 years, CKD-EPI and MDRD showed the highest agreement (Cohen's kappa (K) 0.881 and 0.588, respectively) while CG showed the lowest. After a median follow-up of 407 days, overall mortality was 8.2%. The risk of death was higher in lower eGFR classes (G3b HR4.35; 95%CI 1.05-17.80; G4 HR7.13; 95%CI 1.63-31.23; G5 HR25.91; 95%CI 6.63-101.21). The discriminant capability of death prediction tested with ROC curves showed the best results for BIS-1 and FAS equations.<h4>Conclusion</h4>In our cohort, the concordance between CKD-EPI and other equations decreased with age, with the MDRD formula showing the best agreement in both younger and older patients. Overall, mortality rates increased with the renal function decreasing. In patients aged ≥75 years, the best discriminant capability for death prediction was found for BIS-1 and FAS equations.

Item Type:	Article
Uncontrolled Keywords:	chronic kidney disease, glomerular filtration rate, CKD-EPI, elderly, cardiovascular disease
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	06 May 2022 16:27
Last Modified:	26 Jan 2024 02:17
DOI:	10.3390/jcm11030891
Open Access URL:	https://www.mdpi.com/2077-0383/11/3/891
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3154408