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

Sergey Shikanov, Melanie A. Clark, Jay D. Raman, Benjamin Smith, Matthew Kaag, Paul Russo, Jeffrey C. Wheat, J. Stuart Wolf, William C. Huang, Arieh L. Shalhav, Scott E. Eggener

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1867-1871
Number of pages5
JournalJournal of Urology
Volume184
Issue number5
DOIs
StatePublished - Nov 2010

All Science Journal Classification (ASJC) codes

  • Urology

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