Chronic kidney disease epidemiology collaboration versus modification of diet in renal disease equations for renal function evaluation in patients undergoing partial nephrectomy Journal Article


Authors: Shikanov, S.; Clark, M. A.; Raman, J. D.; Smith, B.; Kaag, M.; Russo, P.; Wheat, J. C.; Wolf, J. S. Jr; Huang, W. C.; Shalhav, A. L.; Eggener, S. E.
Article Title: Chronic kidney disease epidemiology collaboration versus modification of diet in renal disease equations for renal function evaluation in patients undergoing partial nephrectomy
Abstract: Purpose A novel equation, the Chronic Kidney Disease Epidemiology Collaboration, has been proposed to replace the Modification of Diet in Renal Disease for estimated glomerular filtration rate due to higher accuracy, particularly in the setting of normal renal function. We compared these equations in patients with 2 functioning kidneys undergoing partial nephrectomy. Materials and Methods We assembled a cohort of 1,158 patients from 5 institutions who underwent partial nephrectomy between 1991 and 2009. Only subjects with 2 functioning kidneys were included in the study. The end points were baseline estimated glomerular filtration rate, last followup estimated glomerular filtration rate (3 to 18 months), absolute and percent change estimated glomerular filtration rate ([absolute change/baseline] × 100%), and proportion of newly developed chronic kidney disease stage III. The agreement between the equations was evaluated using Bland-Altman plots and the McNemar test for paired observations. Results Mean baseline estimated glomerular filtration rate derived from the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations were 73 and 77 ml/minute/1.73 m2, respectively, and following surgery were 63 and 67 ml/minute/1.73 m2, respectively. Mean percent change estimated glomerular filtration rate was -12% for both equations (p = 0.2). The proportion of patients with newly developed chronic kidney disease stage III following surgery was 32% and 25%, according to the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations, respectively (p = 0.001). Conclusions For patients with 2 functioning kidneys undergoing partial nephrectomy the Chronic Kidney Disease Epidemiology Collaboration equation provides slightly higher glomerular filtration rate estimates compared to the Modification of Diet in Renal Disease equation, with 7% fewer patients categorized as having chronic kidney disease stage III or worse. © 2010 American Urological Association Education and Research, Inc.
Keywords: adult; controlled study; aged; aged, 80 and over; middle aged; young adult; major clinical study; outcome assessment; follow up; accuracy; cohort analysis; creatinine; kidney failure; nephrectomy; disease severity; partial nephrectomy; chronic kidney disease; clinical evaluation; intermethod comparison; glomerular filtration rate; glomerulus filtration rate; kidney function test; chronic; mathematics; kidney failure, chronic; kidney function tests
Journal Title: Journal of Urology
Volume: 184
Issue: 5
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2010-11-01
Start Page: 1867
End Page: 1871
Language: English
DOI: 10.1016/j.juro.2010.06.104
PUBMED: 20846677
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "CODEN: JOURA" - "Source: Scopus"
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  1. Paul Russo
    581 Russo
  2. Matthew G Kaag
    32 Kaag