Risk Stratification of Diabetic Chronic Kidney Disease Using eGFR Equations

Objective?To compare different eGFR equations for risk stratification of diabetic chronic kidney disease．Methods?A total of 601 diabetic patients participated in the study. Data about the patient serum cystatin C (Cys-C), blood urea nitrogen (BUN), creatinine (Scr), uric acid (UA), glycosylated hemoglobin (HbAlc), and urinary albumin creatinine ratio (ACR) were extracted. Simplified MDRD formula were used for calculating glomerular filtration rate (eGFR) using eGFR-EPI_crea,eGFR-EPI_cys and eeGFR-EPI_crea-cys. The patients were divided into three groups according to their urine ACR. Comparisons were made between the groups of patients in Cys-C, BUN, UA, eGFR and Scr. Results?There were significant differences (P<0.05) in Cys-C, eGFR-MDRD,eGFR-EPI_crea, eGFR-EPI_cys, and eGFR-EPI_crea-cys among the groups of patients. The different equations for risk stratification produced different distributions of patients among the three groups. Significant differences appeared among the groups in the distribution of patients using eGFR-MDRD (P<0.05), eGFR-EPI_crea (P=0.000) and eGFR-EPI_cys (P<0.05) and indication for stratification. No significant differences were found in the distribution of patient among the three groups (P＞0.05) using GFR-MDRD, eGFR-EPI_crea and eGFR-EPI_crea-cys as an indication for stratification．In low risk patients, eGFR-MDRD was higher than other eGFR (P<0.05). In medium- and high-risk patients, eGFR-MDRD and eGFR-EPI_crea were higher than eGFR-EPI_cys and eGFR-EPI_crea-cys. In very high-risk patients, the four eGFR did not show differences. Conclusion?The performance of different eGFR equations differs in risk stratification of diabetic chronic kidney disease. In low-risk patients, MDRD equation may overestimate GFR level.