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The eGFR-C study: accuracy of glomerular filtration rate (GFR) estimation using creatinine and cystatin C and albuminuria for monitoring disease progression in patients with stage 3 chronic kidney disease - prospective longitudinal study in a multiethnic population

Lamb, Edmund J., Brettell, Elizabeth A., Cockwell, Paul, Dalton, Neil, Deeks, Jon J., Harris, Kevin, Higgins, Tracy, Kalra, Philip A., Khunti, Kamlesh, Loud, Fiona, and others. (2014) The eGFR-C study: accuracy of glomerular filtration rate (GFR) estimation using creatinine and cystatin C and albuminuria for monitoring disease progression in patients with stage 3 chronic kidney disease - prospective longitudinal study in a multiethnic population. BMC Nephrology, 15 . E-ISSN 1471-2369. (doi:10.1186/1471-2369-15-13) (KAR id:37806)

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Abstract

Background

Iohexol measured GFR will be the reference against which each estimating equation will be compared. The estimating equations will be based upon serum creatinine and/or cystatin C. The eGFR-C study has 5 components:1)A prospective longitudinal cohort study of 1300 adults with stage 3 chronic kidney disease followed for 3 years with reference (measured) GFR and test (estimated GFR [eGFR] and urinary albumin-to-creatinine ratio) measurements at baseline and 3 years. Test measurements will also be undertaken every 6 months. The study population will include a representative sample of south-Asians and African-Caribbeans. People with diabetes and proteinuria (ACR >=30 mg/mmol) will comprise 20-30% of the study cohort.

2)A sub-study of patterns of disease progression of 375 people (125 each of Caucasian, Asian and African-Caribbean origin; in each case containing subjects at high and low risk of renal progression). Additional reference GFR measurements will be undertaken after 1 and 2 years to enable a model of disease progression and error to be built.

3)A biological variability study to establish reference change values for reference and test measures.

4)A modelling study of the performance of monitoring strategies on detecting progression, utilising estimates of accuracy, patterns of disease progression and estimates of measurement error from studies 1), 2) and 3).

5)A comprehensive cost database for each diagnostic approach will be developed to enable cost-effectiveness modelling of the optimal strategy.

The performance of the estimating equations will be evaluated by assessing bias, precision and accuracy. Data will be modelled as a linear function of time utilising all available (maximum 7) time points compared with the difference between baseline and final reference values. The percentage of participants demonstrating large error with the respective estimating equations will be compared. Predictive value of GFR estimates and albumin-to-creatinine ratio will be compared amongst subjects that do or do not show progressive kidney function decline.

Discussion

The eGFR-C study will provide evidence to inform the optimal GFR estimate to be used in clinical practice.

Item Type: Article
DOI/Identification number: 10.1186/1471-2369-15-13
Additional information: Trial registration ISRCTN42955626
Uncontrolled keywords: Albuminuria, Biological variation, Creatinine, Cystatin C, Glomerular filtration rate, Iohexol, Kidney disease
Subjects: H Social Sciences > HT Communities. Classes. Races
R Medicine > RA Public aspects of medicine > RA421 Public health. Hygiene. Preventive Medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tracy Pellatt-Higgins
Date Deposited: 16 Jan 2014 09:47 UTC
Last Modified: 06 May 2020 03:09 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/37806 (The current URI for this page, for reference purposes)
Higgins, Tracy: https://orcid.org/0000-0002-2543-461X
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