Chronic kidney disease epidemiology collaboration-derived glomerular filtration rate performs better at detecting preclinical end-organ changes than alternative equations in black Africans. Issue 6 (June 2016)

• Record Type: Journal Article
• Authors: Booysen, Hendrik L.; Woodiwiss, Angela J.; Raymond, Andrew; Sareli, Pinhas; Hsu, Hon-Chun; Dessein, Patrick H.; Norton, Gavin R.
• Is Part Of: Journal of hypertension. Volume 34:Issue 6(2016:Jun.)
• Publication Date: 2016-06
• Subjects: end-organ changes -- estimated glomerular filtration rate -- African ancestry -- ABW -- actual body weight -- ADBW -- adjusted body weight -- BMI -- body mass index -- BP -- blood pressure -- CKD-EPI -- Chronic Kidney Disease Epidemiology Collaboration -- eGFR -- estimated glomerular filtration rate -- GFR -- glomerular filtration rate -- HbA1c -- percentage glycated haemoglobin -- IBW -- ideal body weight -- IMT -- carotid intima–media thickness -- LBW -- lean body weight -- LVH -- left ventricular hypertrophy -- LVMI -- left ventricular mass index -- LVM -- left ventricular mass -- MDRD -- modification of diet in renal disease -- NBW -- no body weight -- PWV -- aortic pulse wave velocity -- ROC -- receiver operator characteristic; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000000924
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Aim: To identify whether the more recently developed equation for estimated glomerular filtration rate (eGFR) [Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)] is more closely associated with end-organ changes than previous equations in a group of black African descent. Methods: In 1221 randomly recruited participants of black African ancestry in South Africa, we evaluated serum creatinine concentrations, echocardiographic left ventricular mass index ( n = 833), carotid-femoral (aortic) pulse wave velocity (PWV) ( n = 1053) and carotid intima–media thickness ( n = 633). We calculated eGFR from the Jelliffe, five Cockcroft–Gault, Salazar–Corcoran, Modification of Diet in Renal Disease (MDRD) and CKD-EPI equations. Results: After multivariate adjustments, eGFR calculated from all formulae was inversely associated with left ventricular mass index ( P < 0.0001) and PWV ( P < 0.05 to <0.001), but not with carotid intima–media thickness ( P > 0.08). However, although eGFR determined from all equations except Cockcroft–Gault lean body weight or adjusted body weight was independently associated with left ventricular hypertrophy ( n = 390 of 833), CKD-EPI-derived eGFR, but not eGFR determined from alternative equations, was independently associated with an increased PWV ( n = 88 of 1053). eGFR derived from the CKD-EPI and MDRD equations showed a better performance (area under the receiver operator characteristic curve) for the detection of left ventricular hypertrophy ( P < 0.0005) than eGFR determined from alternative equations. Conclusions: In black Africans, eGFR derived from the CKD-EPI equation is better at detecting end-organ measures than eGFR derived from either the MDRD or alternative equations. To enhance risk prediction in black African communities, eGFR calculated from the CKD-EPI equation may be preferred to other equations. Abstract : Supplemental Digital Content is available in the text