Abstract
Impact of the CKD-EPI 2021 Equation on the Classification of CKD in Older Australian Adults: TH-PO1022
Journal of the American Society of Nephrology, Vol.35(10S)
10/2024
DOI: 10.1681/ASN.2024kn8rn7x7
Abstract
Background:
A recalibrated version of CKD-EPI2009, without a race coefficient, was released in 2021 (CKD-EPI2021). This updated equation, implemented in the US, can result in the reclassification of chronic kidney disease (CKD) stage in a significant proportion of individuals. The aim of this study was to investigate the clinical impact of transitioning from the 2009 CKD-EPI (CKD-EPI2009) to the 2021 CKD-EPI (CKD-EPI2021)estimated glomerular filtration rate (eGFR) equationin generally healthy older Australians.
Methods:
This was a prospective cohort study using data from 16,244 Australian community-dwelling adults aged ≥70 years, in the ASPirin in Reducing events in the Elderly (ASPREE) study cohort. Baseline characteristics and long-term health outcomes were compared in participants who were reclassified to a different chronic kidney disease (CKD) stage with CKD-EPI2021 versus those with unchanged classification.
Results:
With CKD-EPI2021,baselineeGFR increased by a median of 3.8 mL/min/1.73m2 (interquartile range [IQR] 3.3, 4.4) resulting in the reclassification of 3,106 (20%) participants to a less advanced CKD stage and the reduction in the prevalence of CKD from 17% to 12%. Over a median follow-up period of 6.5 years (IQR 5.4, 7.9), there was no difference in disability-free survival (HR: 0.94, 95%CI:0.84-1.05), mortality (HR: 0.90, 95%CI:0.78-1.03), major cardiac events (HR: 0.94, 95%CI:0.79-1.13), or hospitalisations for heart failure (HR: 1.00, 95%CI:0.67-1.49) in reclassified, versus non-reclassified, participants.
Conclusion:
Implementing CKD-EPI2021 would raise eGFR by a median of nearly 4 ml/min/1.73m2, substantially reducing the proportion of older Australian adults classified as having CKD with no difference in long-term health outcomes among reclassified people. Transitioning to using the CKD-EPI2021 may result in a significant reduction in nephrology referrals in generally healthy, older adults.
Details
- Title: Subtitle
- Impact of the CKD-EPI 2021 Equation on the Classification of CKD in Older Australian Adults: TH-PO1022
- Creators
- Elisa K. Bongetti - Monash HealthRory Wolfe - Monash UniversityJames B. Wetmore - Hennepin Healthcare Research InstituteAnne M. Murray - Hennepin Healthcare Research InstituteRobyn L. Woods - Monash UniversityMichelle A. Fravel - University of IowaMark Nelson - University of TasmaniaNigel Stocks - University of AdelaideSuzanne G. Orchard - Monash UniversityKevan Polkinghorne - Monash University
- Resource Type
- Abstract
- Publication Details
- Journal of the American Society of Nephrology, Vol.35(10S)
- Publisher
- AMER SOC NEPHROLOGY; WASHINGTON
- DOI
- 10.1681/ASN.2024kn8rn7x7
- ISSN
- 1046-6673
- eISSN
- 1533-3450
- Grant note
- NCINEI
Other NIH Support - NIA, NCI, NEI, Government Support - Non-U.S.
- Language
- English
- Date published
- 10/2024
- Academic Unit
- Pharmacy Practice and Science
- Record Identifier
- 9984740951502771
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