Application of creatinine-based eGFR equations in Chinese septuagenarians and octogenarians.

PURPOSE: The utilization of creatinine-based estimated glomerular filtration rate (eGFR) equations in the adult population is acknowledged. Nevertheless, the appropriateness of creatinine-based eGFR in septuagenarians and octogenarians is debatable. This study evaluates the creatinine-based equations in Chinese septuagenarians and octogenarians cohorts. PATIENTS AND METHODS: This study employed a retrospective design, utilizing a review of the hospital medical records system to identify 347 hospitalized participants within the Division of Geriatrics or the Division of Nephrology. These participants underwent renal dynamic imaging with 99 m Tc-DTPA and serum creatinine testing. Comparison of the equations was performed, including the full age-spectrum equation (FAS-Cr equation), European Kidney Function Consortium equation (EKFC equation), Chronic Kidney Disease Epidemiology Collaboration equation for Asian (Asian CKD-EPI equation), Xiangya equation, and Lund-Malmö revised equation (LMR equation). RESULTS: Most equations tended to underestimate GFR. The FAS-Cr equation had the smallest interquartile range (IQR), while the Asian CKD-EPI equation (mGFR ≥ 30) and Xiangya equation (mGFR < 30) had the biggest IQRs. The FAS-Cr equation had the highest overall P30 of 63.98%, while the Asian CKD-EPI equation had the highest P30 of 75.64% in mGFR ≥ 60. The Xiangya equation, on the other hand, reported the lowest P30 of 36.36% in mGFR < 30. We discovered similar patterns in root-mean-square error (RMSE) as P30. GFR category misclassification rates in the entire cohort ranged from 46.11 to 49.86% for all equations. The FAS-Cr equation exhibited an advantage in octogenarians over other equations in the GFR category misclassification with mGFR lower than 60 ml/min/1.73 m2. CONCLUSION: None of the creatinine-based equations in this study could perform well regarding precision, accuracy, and CKD stages' classification for the Chinese elderly. Nevertheless, the FAS-Cr equation should be suitable for octogenarians with mGFR lower than 60 ml/min/1.73 m2.

Evaluation of glomerular filtration rate by different equations in Chinese elderly with chronic kidney disease.

PURPOSE: Performance of equations in elderly with chronic kidney disease (CKD) was debated. We aimed to access the performances of estimating equations for glomerular filtration rate in Chinese elderly population with chronic kidney disease. METHODS: Participants [N = 218, median age, 82 (range 75-96)] with CKD underwent renal dynamic imaging using technetium-99m diethylene-triamine-penta-acetic acid (99mTc-DTPA). The performances of glomerular filtration rate equations including the Cockcroft-Gault equation, the MDRD (Modification of Diet in Renal Disease) equation for Chinese, 3 CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations, and 2 BIS (Berlin Initiative Study) equations were compared. RESULTS: Median mGFR was 47.62 (3.00-135.00) ml/min/1.73 m2. Smaller biases were shown in BIS-2 equation and CKD-EPI-Cr equation (0.63 ml/min/1.73 m2 and -1.22 ml/min/1.73 m2). Interquartile range of the differences was least with BIS-2 equation and CKD-EPI-Cr-Cys equation (4.36 ml/min/1.73 m2 and 9.17 ml/min/1.73 m2). For accuracy (percentage of eGFR within 30 % of the mGFR, P30), performance of BIS-2, CKD-EPI-Cr-Cys, and BIS-1 equation was superior (94.50, 89.91, and 88.53 %, respectively). In terms of accuracy (root-mean-square error, RMSE), BIS-2 equation, CKD-EPI-Cr-Cys equation, and BIS-1 equation also performed better (7.21 ml/min/1.73 m2, 8.87 ml/min/1.73 m2 and 9.82 ml/min/1.73 m2). GFR category misclassification rates were smaller in BIS-2 equation, CKD-EPI-Cr-Cys equation and BIS-1 equation (16.51, 20.64, and 25.69 %, respectively). CONCLUSION: Compared with other equations, the BIS-2 equation performed better in the estimation of glomerular filtration rate for Chinese elderly with CKD aged 75 or above.