Abstract
Background
Estimated glomerular filtration rate (eGFR) equations can be inaccurate when applied to elderly patients. Newly, the full-age-spectrum (FAS) equation was developed for use in elderly patients.
Aim
We compared the available eGFR equations in elderly Chinese patients with mGFRs < 60 mL/min/1.73 m2.
Methods
Measured glomerular filtration rates (mGFRs) were obtained using 99mTc-DTPA (diethylene-triamine-pentaacetic acid) scans, 220 patients ≥ 80 years with mGFRs < 60 mL/min/1.73 m2 were enrolled. Serum creatinine (SCr) levels were measured simultaneously, and eGFRs based on SCr were calculated using four formulas: the modification of diet in renal disease (MDRD), chronic kidney disease epidemiology collaboration (CKD-EPI-SCr), Berlin initiative study (BIS1), and the FAS-SCr equations.
Results
All the equations tended to overestimate GFR. The FAS-SCr equation provided the least bias (1.84), the highest proportion of eGFR within 30% of mGFR (P30, 72.7%), the bias and P30 of the BIS1 equation were 3.45 and 72.3%, respectively. In patients with mGFRs of 30–60 mL/min/1.73 m2, the BIS1 and FAS-SCr equations demonstrated better performances than the MDRD and CKD-EPI-SCr equations. While in patients with mGFR < 30 mL/min/1.73 m2, the accuracy of all equations was poor.
Discussion
In older patients with mGFRs of 30–60 mL/min/1.73 m2, the BIS1 and the FAS-SCr equations exhibited good performance, none of the equations based on SCr were suitable for older subjects with mGFRs < 30 mL/min/1.73 m2.
Conclusions
The BIS1 and FAS-SCr equations may be optimal for older patients with moderately reduced kidney function.
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Funding
This study was supported by the Capital Health Project of Beijing Science Committee (Grant no: Z131100004013042). The funding body had no role in study design, data collection, data interpretation, or manuscript writing.
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AC designed the experiments, performed the experiments, collected the data, performed the formal analysis and wrote the manuscript. YS, LW, LS, ZY, JJ and JY performed the experiments and collected the data. YS designed experiments. JY designed experiments and reviewed/edited the manuscript. All authors reviewed the results and approved the final version of the manuscript.
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Chen, A., Sun, Y., Li, W. et al. Application of GFR estimation equations in elderly patients with measured GFR below 60 mL/min/1.73 m2. Aging Clin Exp Res 32, 415–422 (2020). https://doi.org/10.1007/s40520-019-01218-2
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DOI: https://doi.org/10.1007/s40520-019-01218-2