Comparison between three different equations for the estimation of glomerular filtration rate in predicting mortality after coronary artery bypass

Sandro Gelsomino*, Massimo Bonacchi, Fabiana Luca, Fabio Barili, Stefano Del Pace, Orlando Parise, Daniel M. Johnson, Michele Massimo Gulizia

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background This study was undertaken to compare the accuracy of chronic kidney disease-epidemiology collaboration (eGFR(CKD-EPI)) to modification of diet in renal disease (eGFR(MDRD)) and the Cockcroft-Gault formulas of Creatinine clearance (C-CG) equations in predicting post coronary artery bypass grafting (CABG) mortality. Methods Data from 4408 patients who underwent isolated CABG over a 11-year period were retrieved from one institutional database. Discriminatory power was assessed using the c-index and comparison between the scores' performance was performed with DeLong, bootstrap, and Venkatraman methods. Calibration was evaluated with calibration curves and associated statistics. Results The discriminatory power was higher in eGFR(CKD-EPI) than eGFR(MDRD) and C-CG (Area under Curve [AUC]:0.77, 0.55 and 0.52, respectively). Furthermore, eGFR(CKD-EPI) performed worse in patients with an eGFR = 60 ml/min/1.73m(2) (p = 0.48). Conclusions In general, CKD-EPI gives the best prediction of death after CABG with unsatisfactory accuracy and calibration only in patients with severe kidney disease. In contrast, the CG and MDRD equations were inaccurate in a clinically significant proportion of patients.

Original languageEnglish
Article number371
Number of pages13
JournalBmc Nephrology
Volume20
Issue number1
DOIs
Publication statusPublished - 16 Oct 2019

Keywords

  • Coronary artery bypass
  • Renal function
  • Glomerular filtration
  • Risk score
  • CHRONIC KIDNEY-DISEASE
  • RENAL-DISEASE
  • COCKCROFT-GAULT
  • CARDIOVASCULAR OUTCOMES
  • TERM OUTCOMES
  • RISK-FACTOR
  • PERFORMANCE
  • IMPACT
  • SURGERY
  • DIET

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