The practicality of different eGFR equations in centenarians and near-centenarians: which equation should we choose?

Qiuxia Han; Dong Zhang; Yali Zhao; Liang Liu; Jing Li; Fu Zhang; Fuxin Luan; Jiayu Duan; Zhangsuo Liu; Guangyan Cai; Xiangmei Chen; Hanyu Zhu

doi:10.7717/peerj.8636

The practicality of different eGFR equations in centenarians and near-centenarians: which equation should we choose?

PeerJ. 2020 Feb 21:8:e8636. doi: 10.7717/peerj.8636. eCollection 2020.

Authors

Qiuxia Han^#^{1

2

3}, Dong Zhang^#¹, Yali Zhao⁴, Liang Liu⁵, Jing Li⁵, Fu Zhang⁵, Fuxin Luan⁵, Jiayu Duan³, Zhangsuo Liu³, Guangyan Cai^{1

2}, Xiangmei Chen^{1

2}, Hanyu Zhu¹

Affiliations

¹ Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China.
² School of Medicine, Nankai University, Tianjin, China.
³ The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology of Zhengzhou University, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China.
⁴ Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, China.
⁵ Management Department, Hainan Branch of Chinese PLA General Hospital, Sanya, China.

^# Contributed equally.

Abstract

Background: No studies have examined the practicality of the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and Berlin Initiative Study 1 (BIS1) equations for the estimated glomerular filtration rate (eGFR) in a large sample of centenarians. We aim to investigate the differences among the equations and suggest the most suitable equation for centenarians and near-centenarians.

Methods: A total of 966 centenarians and 787 near-centenarians were enrolled, and the eGFR was calculated using the three equations mentioned above. Agreement among the equations was investigated with the κ statistic and Bland-Altman plots. Sources of discrepancy were investigated using a partial correlation analysis.

Results: The three equations for assessing eGFR are not considered interchangeable in centenarians and near-centenarians. Δ(MDRD, CKD-EPI) and Δ(MDRD, BIS1) increased with age, but Δ(CKD-EPI, BIS1) was relatively stable with age. Δ(MDRD, CKD-EPI) and Δ(MDRD, BIS1) were considerable in subjects with Scr levels less than 0.7 mg/dL and decreased with the Scr level. A considerable difference between CKD-EPI and BIS1 was observed for participants with Scr levels ranging from 0.5 to 1.5 mg/dL. This difference increased with Scr levels ranging from 0.5 to 0.7 mg/dL, was relatively stable for Scr levels ranging from 0.7 to 0.9 mg/dL, and decreased with Scr levels ranging from 0.9 to 1.5 mg/dL. The differences in the three comparisons were all greater in women than in men (p < 0.05).

Conclusions: We tend to suggest the MDRD equation to calculate the glomerular filtration rate (GFR) in elderly individuals >95 years old who have no risk factors for cardiovascular disease; the BIS1 equation to calculate the eGFR for elderly individuals younger than 94 years old who have risk factors for cardiovascular disease; the CKD-EPI equation to calculate the eGFR of elderly individuals with Scr levels greater than 1.5 mg/dL; and the BIS1 equation to calculate the eGFR of older women with Scr levels less than 0.7 mg/dL.

Keywords: BIS1 equation; CKD-EPI equation; Centenarians; MDRD equation; eGFR.

Grants and funding

This work was supported by grants from National Key R&D Program of China (No. 2016YFC1305500), the Key Research and Development Program of Hainan (Nos. ZDYF2016135, ZDYF2017095), the National Key R&D Program of China (2018YFA0108800), the National Natural Science Foundation of China (Nos. 61971441, 61671479, U1604284, 81670663), and the National Key Research and Development Program (No. 2016YFC1305404). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.