Abstract: FR-PO938

How Do Creatinine Based GFR Equations Perform in Chinese Nonagenarians

Session Information

  • Geriatric Nephrology
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Geriatric Nephrology

  • 901 Geriatric Nephrology

Authors

  • Wang, Mengjing, Huashan Hosopital, Fudan Univeristy, Shanghai, China
  • Dong, Xinyu, Huashan Hospital affiliated to Fudan University, Shanghai, China
  • Zhang, Minmin, Huashan Hospital, Fudan Univerisy, Shanghai, China
  • Ni, Li, Huashan Hospital affiliated to Fudan University, Shanghai, China
  • Liu, Zuyun, Fudan University, Shanghai, Shanghai, China
  • Wang, Xiaofeng, Fudan University, Shanghai, Shanghai, China
  • Chen, Jing, Huashan Hospital affiliated to Fudan University, Shanghai, China
Background

The clinical and prognostic meaning of evaluating Glomerular filtration rate (GFR) may be different in the very old population. This study aimed to elucidate the performance and predictive value of 4 GFR estimation equations in Chinese nonagenarians.

Methods

We calculated baseline eGFR from serum creatinine using the CKD epidemiology collaboration (CKD-EPI) equation, the Modification of Diet in Renal Disease Study (MDRD) equation, Berlin Initiative Study-1 (BIS1) equation, and modified MDRD equation from Chinese population in 278 nonagenarians from the Rugao longevity cohort over the period of 2007 to 2014. We compared the association of GFR estimated from 4 equations with risk of all-cause mortality using fully-adjusted Cox model. Overall improvement in reclassification based on clinical eGFR categories was assessed applying net reclassification improvement (NRI).

Results

Mean age of participants was 97±2 years old with 77% of women. Follow-up time was 2.8±1.8 years. Median (IQR) eGFR by CKD-EPI, MDRD, BIS, and modified MDRD equations were 73.9 (62.2–77.6), 87.5 (71.7–104.8), 56.4 (47.9–63.9), and 107.9 (88.4–129.2) ml/min per 1.73m2, respectively. Higher eGFREPI was associated with lower mortality after multivariate adjustment which includes frailty (for continuous eGFREPI: HR 0.987, 95%CI 0.976-0.998; for categorical eGFREPI: HR 0.782, 95%CI 0.628-0.945), while GFR estimated from other equations didn’t show any associations with mortality. NRI for death by the CKD-EPI equation compared to MDRD, BIS1 and modified MDRD equations was 0.06, 0.06, and 0.03 (P>0.05 for all), respectively.

Conclusion

The CKD-EPI equation showed more appropriate estimation of GFR in long-lived individuals with respect to GFR distribution and risk of long-term mortality as compared to the other equations, suggesting improved clinical usefulness in Chinese nonagenarians.

Funding

  • Government Support - Non-U.S.