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The e-GFR 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: an observational study in a multiethnic population.

The aims of the research are to evaluate glomerular filtration rate (GFR)- estimating equations in assessing and monitoring measured GFR in people with stage 3 chronic kidney disease (CKD) over three years. A focus of the research is the impact of ethnic group, baseline diabetes and proteinuria in the estimation and evaluation of how accurately these equations reflect change in GFR over three years. A further aim of the research is to estimate and model disease progression and compare the effectiveness and costs of monitoring strategies for identifying people that have progressive loss of kidney function utilising different GFR-estimating equations and test schedules, accounting for differences in risk of progression.

An accurate knowledge of GFR is required to identify and manage CKD. Measurement of GFR using reference procedures is impractical for large scale application, and GFR-estimating equations are widely used. There is little data addressing the ability of estimated GFR to detect change in true GFR, and no data addressing the accuracy of these equations in British ethnic minority populations. The evidence base on the frequency of monitoring is also very poor for some of the newer estimating equations, and whether the benefits of these new equations are outweighed by the increased costs. This study has been designed to address these questions.

A prospective multi-centre longitudinal cohort study to estimate accuracy in eGFR and changes in eGFR. 1300 people will be followed for 3 years with reference (measured) GFR and test (estimated GFR – eGFR) measurements at baseline and 3 years. Test measurements are also undertaken every 6 months. The target population are adults with stage 3 CKD proportionally enriched to include people more likely to have progressive kidney disease (i.e. those with proteinuria and/or diabetes) and including Asians and African-Caribbeans.

A sub-study of 300 people (100 each of Caucasian, Asian and African-Caribbean origin; in each case containing subjects at high and low risk of kidney disease progression) will also be undertaken. Reference GFR will be measured yearly in the sub-study population and patterns of disease progression assessed.

Start date: 01/08/2013 End date: 31/01/2019

Funder: NIHR via EKHUFT

Funding: £25,912

Publication: The eGFR-C study

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Last Updated: 04/03/2019