Table of Contents Author Guidelines Submit a Manuscript
International Journal of Nephrology
Volume 2017, Article ID 8216878, 10 pages
https://doi.org/10.1155/2017/8216878
Research Article

Renal Function and Death in Older Women: Which eGFR Formula Should We Use?

1Malcom-Randall VAMC, Department of Medicine, University of Florida, Gainesville, FL, USA
2Research Institute, California Pacific Medical Center, San Francisco, CA, USA
3Department of Medicine, University of Minnesota, Minneapolis VA Health Care System, Minneapolis, MN, USA
4Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
5Hennepin County Medical Center, Minneapolis, MN, USA
6Malcom-Randall VAMC GRECC, Department of Medicine, University of Florida, Gainesville, FL, USA

Correspondence should be addressed to Muna T. Canales; ude.lfu.enicidem@selanac.anum

Received 18 October 2016; Revised 16 February 2017; Accepted 1 March 2017; Published 29 March 2017

Academic Editor: Ziyad Al-Aly

Copyright © 2017 Muna T. Canales et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The Berlin Initiative Study (BIS) eGFR equations were developed specifically for aged populations, but their predictive validity compared to standard formulae is unknown in older women. Methods. In a prospective study of 1289 community-dwelling older women (mean age 79.5 years), we compared the performance of the BIS1 SCr-based equation to the CKD- and the BIS2 SCr- and Scysc-based equation to the CKD- to predict cardiovascular and all-cause mortality. Results. Prevalence of specific eGFR category (i.e., ≥75, 60–74, 45–59, and <45) according to eGFR equation was 12.3%, 38.4%, 37.3%, and 12.0% for BIS1; 48.3%, 27.8%, 16.2%, and 7.8% for CKD-; 14.1%, 38.6%, 37.6%, and 9.6% for BIS2; and 33.5%, 33.4%, 22.0%, and 11.1% for CKD-, respectively. Over years, 667 (51.8%) women died. For each equation, women with eGFR <45 were at increased risk of mortality compared to eGFR ≥75 [adjusted HR (95% CI): BIS1, 1.5 (1.1–2.0); CKD-, 1.7 (1.3–2.2); BIS2, 2.0 (1.4–2.8); CKD-, 1.8 (1.4–2.3); p-trend <0.01]. Net reclassification analyses found no material difference in discriminant ability between the BIS and CKD-EPI equations. Results were similar for cardiovascular death. Conclusions. Compared to CKD-EPI, BIS equations identified a greater proportion of older women as having CKD but performed similarly to predict mortality risk. Thus, the BIS equations should not replace CKD-EPI equations to predict risk of death in older women.