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	<title>Kidney Function &#187; Sarah L. White, Kevan R. Polkinghorne, Robert C. Atkins, Steven J. Chadban</title>
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	<description>Renal Information</description>
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		<title>Comparison of the Prevalence and Mortality Risk of CKD in Australia Using the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study GFR Estimating Equations: The AusDiab (Australian Diabetes, Obesity and Lifestyle) Study &#8211; Corrected Proof</title>
		<link>http://kidneyfunction.org/comparison-of-the-prevalence-and-mortality-risk-of-ckd-in-australia-using-the-ckd-epidemiology-collaboration-ckd-epi-and-modification-of-diet-in-renal-disease-mdrd-study-gfr-estimating-equations/</link>
		<comments>http://kidneyfunction.org/comparison-of-the-prevalence-and-mortality-risk-of-ckd-in-australia-using-the-ckd-epidemiology-collaboration-ckd-epi-and-modification-of-diet-in-renal-disease-mdrd-study-gfr-estimating-equations/#comments</comments>
		<pubDate>Mon, 08 Feb 2010 03:00:00 +0000</pubDate>
		<dc:creator>Sarah L. White, Kevan R. Polkinghorne, Robert C. Atkins, Steven J. Chadban</dc:creator>
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		<guid isPermaLink="false">10.1053/j.ajkd.2009.12.011</guid>
		<description><![CDATA[Background: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) is more accurate than the Modification of Diet in Renal Disease (MDRD) Study equation. We applied both equations in a cohort representative of the Australian adult population.Study Design: Population-based cohort study.Setting &#38; Participants: 11,247 randomly selected noninstitutionalized Australians aged ≥ 25 years who attended a physical examination during the baseline AusDiab (Australian Diabetes, Obesity and Lifestyle) Study survey.Predictors &#38; Outcomes: Glomerular filtration rate (GFR) was estimated using the MDRD Study and CKD-EPI equations. Kidney damage was defined as urine albumin-creatinine ratio ≥ 2.5 mg/mmol in men and ≥ 3.5 mg/mmol in women or urine protein-creatinine ratio ≥ 0.20 mg/mg. Chronic kidney disease (CKD) was defined as estimated GFR (eGFR) ≥ 60 mL/min/1.73 m2 or kidney damage. Participants were classified into 3 mutually exclusive subgroups: CKD according to both equations; CKD according to the MDRD Study equation, but no CKD according to the CKD-EPI equation; and no CKD according to both equations. All-cause mortality was examined in subgroups with and without CKD.Measurements: Serum creatinine and urinary albumin, protein, and creatinine measured on a random spot morning urine sample.Results: 266 participants identified as having CKD according to the MDRD Study equation were reclassified to no CKD according to the CKD-EPI equation (estimated prevalence, 1.9%; 95% CI, 1.4-2.6). All had an eGFR ≥ 45 mL/min/1.73 m2 using the MDRD Study equation. Reclassified individuals were predominantly women with a favorable cardiovascular risk profile. The proportion of reclassified individuals with a Framingham-predicted 10-year cardiovascular risk ≥ 30% was 7.2% compared with 7.9% of the group with no CKD according to both equations and 45.3% of individuals retained in stage 3a using both equations. There was no evidence of increased all-cause mortality in the reclassified group (age- and sex-adjusted hazard ratio vs no CKD, 1.01; 95% CI, 0.62-1.97). Using the MDRD Study equation, the prevalence of CKD in the Australian population aged ≥ 25 years was 13.4% (95% CI, 11.1-16.1). Using the CKD-EPI equation, the prevalence was 11.5% (95% CI, 9.42-14.1).Limitations: Single measurements of serum creatinine and urinary markers.Conclusions: The lower estimated prevalence of CKD using the CKD-EPI equation is caused by reclassification of low-risk individuals. Am J Kidney Dis 00:00-00]]></description>
			<content:encoded><![CDATA[Background: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) is more accurate than the Modification of Diet in Renal Disease (MDRD) Study equation. We applied both equations in a cohort representative of the Australian adult population.Study Design: Population-based cohort study.Setting & Participants: 11,247 randomly selected noninstitutionalized Australians aged ≥ 25 years who attended a physical examination during the baseline AusDiab (Australian Diabetes, Obesity and Lifestyle) Study survey.Predictors & Outcomes: Glomerular filtration rate (GFR) was estimated using the MDRD Study and CKD-EPI equations. Kidney damage was defined as urine albumin-creatinine ratio ≥ 2.5 mg/mmol in men and ≥ 3.5 mg/mmol in women or urine protein-creatinine ratio ≥ 0.20 mg/mg. Chronic kidney disease (CKD) was defined as estimated GFR (eGFR) ≥ 60 mL/min/1.73 m2 or kidney damage. Participants were classified into 3 mutually exclusive subgroups: CKD according to both equations; CKD according to the MDRD Study equation, but no CKD according to the CKD-EPI equation; and no CKD according to both equations. All-cause mortality was examined in subgroups with and without CKD.Measurements: Serum creatinine and urinary albumin, protein, and creatinine measured on a random spot morning urine sample.Results: 266 participants identified as having CKD according to the MDRD Study equation were reclassified to no CKD according to the CKD-EPI equation (estimated prevalence, 1.9%; 95% CI, 1.4-2.6). All had an eGFR ≥ 45 mL/min/1.73 m2 using the MDRD Study equation. Reclassified individuals were predominantly women with a favorable cardiovascular risk profile. The proportion of reclassified individuals with a Framingham-predicted 10-year cardiovascular risk ≥ 30% was 7.2% compared with 7.9% of the group with no CKD according to both equations and 45.3% of individuals retained in stage 3a using both equations. There was no evidence of increased all-cause mortality in the reclassified group (age- and sex-adjusted hazard ratio vs no CKD, 1.01; 95% CI, 0.62-1.97). Using the MDRD Study equation, the prevalence of CKD in the Australian population aged ≥ 25 years was 13.4% (95% CI, 11.1-16.1). Using the CKD-EPI equation, the prevalence was 11.5% (95% CI, 9.42-14.1).Limitations: Single measurements of serum creatinine and urinary markers.Conclusions: The lower estimated prevalence of CKD using the CKD-EPI equation is caused by reclassification of low-risk individuals. Am J Kidney Dis 00:00-00]]></content:encoded>
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