Comparison of predictability of future cardiovascular events between chronic kidney disease (CKD) stage based on CKD epidemiology collaboration equation and that based on modification of diet in renal disease equation in the Japanese general population - Iwate Kenco study -

Masaki Ohsawa, Kozo Tanno, Kazuyoshi Itai, Tanvir Chowdhury Turin, Tomonori Okamura, Akira Ogawa, Kuniaki Ogasawara, Tomoaki Fujioka, Toshiyuki Onoda, Yuki Yoshida, Shin Ichi Omama, Yasuhiro Ishibashi, Motoyuki Nakamura, Shinji Makita, Fumitaka Tanaka, Toru Kuribayashi, Tomiko Koyama, Kiyomi Sakata, Akira Okayama

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22 Citations (Scopus)

Abstract

Background:Whether estimated glomerular filtration rate (eGFR) calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Study equation (eGFRCKDEPI) improves risk prediction compared to that calculated using the Modification of Diet in Renal Disease (MDRD) study equation (eGFRMDRD) has not been examined in a prospective study in Japanese people. Methods and Results:Participants (n=24,560) were divided into 4 stages (1, ≥90; 2, 60-89 (reference); 3a, 45-59; -2) according to eGFRCKDEPI or eGFRMDRD. Endpoints were all-cause death, myocardial infarction (MI) and stroke. Area under the receiver operating characteristic curves (95% confidence intervals) for predicting all-cause death, MI and stroke by eGFRCKDEPI vs. eGFRMDRD were 0.680 (0.662-0.697) vs. 0.582 (0.562-0.602); 0.718 (0.665-0.771) vs. 0.642 (0.581-0.703); and 0.656 (0.636-0.676) vs. 0.576 (0.553-0.599), respectively. Multivariate-adjusted Cox regression and Poisson regression analysis results were similar for adjusted incidence rates and adjusted hazard ratios in each corresponding stage between the 2 models and no differences were found in model assessment parameters. Net reclassification improvement (NRI) for predicting all-cause death, MI and stroke were estimated to be 6.7% (P<0.001), -1.89% (P=0.029) and -0.20% (P=0.421), respectively. Conclusions:Better discrimination was achieved using eGFRCKDEPI than eGFRMDRD on univariate analysis. NRI analysis indicated that the use of eGFRCKDEPI instead of eGFRMDRD offered a significant improvement in reclassification of death risk.

Original languageEnglish
Pages (from-to)1315-1325
Number of pages11
JournalCirculation Journal
Volume77
Issue number5
DOIs
Publication statusPublished - 2013 May 1

Keywords

  • CKD-EPI equation
  • Chronic kidney disease
  • Estimated glomerular filtration rate
  • Mdrd equation
  • Model assessment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Ohsawa, M., Tanno, K., Itai, K., Turin, T. C., Okamura, T., Ogawa, A., Ogasawara, K., Fujioka, T., Onoda, T., Yoshida, Y., Omama, S. I., Ishibashi, Y., Nakamura, M., Makita, S., Tanaka, F., Kuribayashi, T., Koyama, T., Sakata, K., & Okayama, A. (2013). Comparison of predictability of future cardiovascular events between chronic kidney disease (CKD) stage based on CKD epidemiology collaboration equation and that based on modification of diet in renal disease equation in the Japanese general population - Iwate Kenco study -. Circulation Journal, 77(5), 1315-1325. https://doi.org/10.1253/circj.CJ-12-0982