Background: Recently, the Kidney Disease: Improving Global Outcomes (KDIGO) group recommended that\r\npatients with CKD should be assigned to stages and composite relative risk groups according to GFR (G) and\r\nproteinuria (A) criteria. Asians have among the highest rates of ESRD in the world, but establishing the prevalence\r\nand prognosis CKD is a problem for Asian populations since there is no consensus on the best GFR estimating\r\n(eGFR) equation. We studied the effects of the choice of new Asian and Caucasian eGFR equations on CKD\r\nprevalence, stage distribution, and risk categorization using the new KDIGO classification.\r\nMethods: The prevalence of CKD and composite relative risk groups defined by eGFR from with Chronic Kidney\r\nDisease-Epidemiology Collaboration (CKD-EPI); standard (S) or Chinese(C) MDRD; Japanese CKD-EPI (J-EPI), Thai GFR\r\n(T-GFR) equations were compared in a Thai cohort (n = 5526)\r\nResults: There was a 7 fold difference in CKD3-5 prevalence between J-EPI and the other Asian eGFR formulae.\r\nCKD3-5 prevalence with S-MDRD and CKD-EPI were 2 - 3 folds higher than T-GFR or C-MDRD. The concordance\r\nwith CKD-EPI to diagnose CKD3-5 was over 90% for T-GFR or C-MDRD, but they only assigned the same CKD stage\r\nin 50% of the time. The choice of equation also caused large variations in each composite risk groups especially\r\nthose with mildly increased risks. Different equations can lead to a reversal of male: female ratios. The variability of\r\ndifferent equations is most apparent in older subjects. Stage G3aA1 increased with age and accounted for a large\r\nproportion of the differences in CKD3-5 between CKD-EPI, S-MDRD and C-MDRD.\r\nConclusions: CKD prevalence, sex ratios, and KDIGO composite risk groupings varied widely depending on the\r\nequation used. More studies are needed to define the best equation for Asian populations.
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