Skip to main content

Advertisement

Log in

Association of reduced kidney function with cardiovascular disease and mortality in elderly patients: comparison between the new Berlin initiative study (BIS1) and the MDRD study equations

  • Original Article
  • Published:
Journal of Nephrology Aims and scope Submit manuscript

Abstract

Background

New creatinine based equations for estimating glomerular proposed for aged subjects have not been assessed in their association of reduced eGFR with cardiovascular (CV) morbidity or all cause (AC) mortality.

Patients

All subjects ≥70 years old (2998) who had been admitted to the hospital during a 12 month period were examined.

Methods

In a cohort study we applied the new Berlin Initiative Study (BIS1) equation. We compared the association of reduced eGFR estimated by BIS1 and MDRD equations, with cardiovascular (CV) disease and all cause (AC) mortality.

Results

eGFR was 57 ± 17 mL/min/1.73 m2 by MDRD and 71 ± 28 mL/min/1.73 m2 by BIS1 (P < 0.001). A diagnosis of CV disease was present in 947 patients. CV disease was associated with eGFR < 60 mL/min/1.73 m2 by both formulas: OR 1.179 (CI 1.001–1.390) for BIS1 and OR 1.440 (CI 1.223–1.696) for MDRD. In survival analysis a significant association of eGFR < 60 mL/min/1.73 m2 with AC mortality was found for both equations: MDRD (HR = 1.270, CI 1.111–1.453, P < 0.001), BIS1 (HR = 1.174, CI 1.031–1.338, P = 0.016). The analysis repeated with groups of age showed that the association of mortality with eGFRBIS1 < 60 mL/min/1.73 m2 was lost over 80 years.

Conclusions

In patients >70, admitted to hospital, the implementation of the new BIS1 estimating equation does not modify the relationship, observed with the MDRD formula, of reduced GFR with CV disease or AC mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Hallan SI, Matsushita K, Sang Y et al (2012) Chronic Kidney Disease Prognosis Consortium. Age and association of kidney measures with mortality and end-stage renal disease. JAMA 308:2349–2360

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, Gansevoort RT, Kasiske BL, Eckardt KU (2011) The definition, classification, and prognosis of chronic kidney disease: a KDIGO controversies conference report. Kidney Int 80:17–28

    Article  PubMed  Google Scholar 

  3. Losito A, Pittavini L, Ferri De Angelis L (2012) Reduced kidney function and outcome in acute ischaemic stroke: relationship to arterial hypertension and diabetes. Nephrol Dial Trans 27:1054–1058

    Article  CAS  PubMed  Google Scholar 

  4. Losito A, Pittavini L, Ferri C, De Angelis L (2011) Kidney function and mortality in different cardiovascular diseases: relationship with age, sex, diabetes and hypertension. J Nephrol 24:322–328

    Article  PubMed  Google Scholar 

  5. Moynihan R, Glassock R, Doust J (2013) Chronic kidney disease controversy: how expanding definitions are unnecessarily labeling many people as diseased. BMJ 347:f4298

    Article  PubMed  Google Scholar 

  6. Schaeffner ES, Ebert N, Delanaye P et al (2012) Two novel equations to estimate kidney function in persons aged 70 years or older. Ann Intern Med 157:471–481

    Article  PubMed  Google Scholar 

  7. Lopes MB, Araújo LQ, Passos MT, Nishida SK, Kirsztajn GM, Cendoroglo MS, Sesso RC (2013) Estimation of glomerular filtration rate from serum creatinine and cystatin C in octogenarians and nonagenarians. BMC Nephrol 14:265

  8. Koppe L, Klich A, Dubourg L, Ecochard R, Hadj-Aissa A (2013) Performance of creatinine-based equations compared in older patients. J Nephrol 26:716–723

    Article  CAS  PubMed  Google Scholar 

  9. Hallan SI, Gansevoort RT (2014) Should we diagnose CKD using the ‘one-size fits all’ KDIGO 2012 guideline or do we need a more complex age-specific classification system? Nephrol Dial Transplant 29:780–782

    Article  Google Scholar 

  10. Carobene A, Ferrero C, Ceriotti F, Modenese A, Besozzi M, de Giorgi E, Franzini M, Franzini C, Kienle MG, Magni F (1997) Creatinine measurement proficiency testing: assignment of matrix-adjusted ID GC-MS target values. Clin Chem 43(1342):1347

    Google Scholar 

  11. Levey AS, Greene T, Kusek JW, Beck GJ, MDRD Study Group (2000) A simplified equation to predict glomerular filtration rate from serum creatinine [abstract]. J Am Soc Nephrol 11:0828

    Google Scholar 

  12. Alshaer IM, Kilbride HS, Stevens PE et al (2014) External validation of the Berlin equations for estimation of GFR in the elderly. Am J Kidney Dis 63:862–865

    Article  PubMed  Google Scholar 

  13. Vidal-Petiot E, Haymann JP, Letavernier E et al (2014) External validation of the BIS (Berlin Initiative Study)-1 GFR estimating equation in the elderly. Am J Kidney Dis 63:865–867

  14. Esposito C, Torreggiani M, Arazzi M et al (2012) Loss of Renal Function in the Elderly Italians: a Physiologic or Pathologic Process? J Gerontol A Biol Sci Med Sci 67:1387–1393

    Article  PubMed  Google Scholar 

  15. Péquignot R, Belmin J, Chauvelier S et al (2009) Renal function in older hospital patients is more accurately estimated using the Cockcroft-Gault formula than the modification diet in renal disease formula. J Am Geriatr Soc 57:1638–1643

    Article  PubMed  Google Scholar 

  16. Matsushita K, Selvin E, Bash LD, Astor BC, Coresh J (2010) Risk implications of the new CKD Epidemiology Collaboration (CKD-EPI) equation compared with the MDRD Study equation for estimated GFR: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis 55:648–659

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chowdhury EK, Langham RG, Owen A et al (2015) Comparison of Predictive Performance of Renal Function Estimation Equations for All-Cause and Cardiovascular Mortality in an Elderly Hypertensive Population. Am J Hypertens 28:380–386

    Article  PubMed  Google Scholar 

  18. Weiner DE, Tighiouart H, Amin MG et al (2004) Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol 15:1307–1315

    Article  PubMed  Google Scholar 

  19. Stevens LA, Coresh J, Feldman HI et al (2007) Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol 18:2749–2757

    Article  PubMed  Google Scholar 

  20. Shlipak MG, Matsushita K, Ärnlöv J et al (2013) CKD Prognosis Consortium. Cystatin C versus creatinine in determining risk based on kidney function. N Engl J Med 369:932–943

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Attilio Losito.

Ethics declarations

Conflict of interest

None of the authors has a conflict of interest. No financial support was requested to conduct this study.

Ethical approval

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.

Informed consent

For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Losito, A., Zampi, I., Pittavini, L. et al. Association of reduced kidney function with cardiovascular disease and mortality in elderly patients: comparison between the new Berlin initiative study (BIS1) and the MDRD study equations. J Nephrol 30, 81–86 (2017). https://doi.org/10.1007/s40620-015-0244-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40620-015-0244-7

Keywords

Navigation