Diagnostic accuracy of different methods of early detection of chronic kidney disease
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To assess the accuracy of the CG, CG-corrected, MDRD-6, MDRD-4 and CKD-EPI formulae when diagnosing CKD and to compare the results for creatinine clearance.
Subject and methods
This cross-sectional study was conducted with hypertensive individuals monitored by the Primary Health Care Service in Brazil (n = 293). Renal function was analyzed based on serum creatinine levels and creatinine clearance (24 h). The GFR was estimated using the CG, CG-corrected, MDRD-6, MDRD-4 and CKD-EPI formulae. The accuracy of the CKD diagnosis was assessed by analyzing sensitivity and specificity with confidence intervals (95%), receiver-operator characteristic (ROC) curve and the area under the curve (AUC) values.
The CKD-EPI formula provided the best balance between sensitivity, 76.7 (66.4–85.2), and specificity, 71.9 (65.3–78.0), as well as the highest AUC value (0.808). Concerning the ROC analysis, the curve of the CKD-EPI formula confirmed its greater precision.
The results of the present study indicate that the CKD-EPI formula is the best method for estimating the GFR. Thus, it is possible to implement low-cost actions focused on the early detection and prevention of complications of CKD.
KeywordsChronic kidney disease Disease prevention Early diagnosis Kidney function tests
Compliance with ethical standards
This study received support from the Foundation for Research Support in the State of Minas Gerais, Brazil (FAPEMIG-process no. CDS-APQ-03594-12) and the Coordination for the Improvement of Higher Education (CAPES), an entity of the Brazilian Government that coordinates human resources (AUX-PE-PRO-HEALTH EDUCATION 2034/2010–process no. 23038.009788/2010-78).
Disclosure of potential conflicts of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
The present study was approved by the Human Research Ethics Committee of the Universidade Federal de Viçosa (UFV) under protocol no. 044/2012.
Informed consent was obtained from all individual participants included in the study. As per Resolution 466/2012 of the National Health Council, which regulates research involving human subjects, the participants signed a free and informed statement of consent, which ensured the confidentiality of the data and the anonymity of the participants.
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