Aili A, Li RY, Mohammed AA, Zhao S, Li MR, Li HN, Xu YW, Zhang Y. Prognostic value of glomerular-filtration-rate estimated by common and modified Asian/Chinese equations for cardiovascular outcomes in elderly Chinese individuals. World J Cardiol 2026; 18(6): 119376 [DOI: 10.4330/wjc.119376]
Corresponding Author of This Article
Yi Zhang, MD, PhD, Professor, Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, No. 301 Yanchang Road, Shanghai 200072, China. yizshcn@gmail.com
Research Domain of This Article
Geriatrics & Gerontology
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research-article
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Aili A, Li RY, Mohammed AA, Zhao S, Li MR, Li HN, Xu YW, Zhang Y. Prognostic value of glomerular-filtration-rate estimated by common and modified Asian/Chinese equations for cardiovascular outcomes in elderly Chinese individuals. World J Cardiol 2026; 18(6): 119376 [DOI: 10.4330/wjc.119376]
World J Cardiol. Jun 26, 2026; 18(6): 119376 Published online Jun 26, 2026. doi: 10.4330/wjc.119376
Prognostic value of glomerular-filtration-rate estimated by common and modified Asian/Chinese equations for cardiovascular outcomes in elderly Chinese individuals
Atawula Aili, Rui-Yuan Li, Ayman A Mohammed, Song Zhao, Mo-Ran Li, Hao-Nan Li, Ya-Wei Xu, Yi Zhang
Atawula Aili, Department of Cardiology, The First People’s Hospital of Kashgar District, Kashgar 844000, Xinjiang Uygur Autonomous Region, China
Atawula Aili, Ayman A Mohammed, Song Zhao, Mo-Ran Li, Hao-Nan Li, Ya-Wei Xu, Yi Zhang, Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China
Rui-Yuan Li, Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing 101199, China
Co-first authors: Atawula Aili and Rui-Yuan Li.
Co-corresponding authors: Ayman A Mohammed and Yi Zhang.
Author contributions: Aili A and Li RY made equal contributions to this work as co-first authors; Mohammed AA, Aili A, Li RY, Zhao S, and Li MR designed and conducted the study and wrote the paper; Mohammed AA, Li RY, and Zhang Y contributed to data analysis; Li HN, Li MR, and Xu YW provided clinical advice; and Mohammed AA, Xu YW, and Zhang Y supervised the study. Mohammed AA and Zhang Y contributed equally to this work as co-corresponding authors. All authors approved the final version to be published.
Supported by National Nature Science Foundation of China, No. 82570350.
Institutional review board statement: This study was approved by the Institutional Review Board of Shanghai Tenth People’s Hospital.
Informed consent statement: All participants provided informed consent before enrollment in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The corresponding author will provide the dataset generated and analyzed in this study upon reasonable request.
Corresponding author: Yi Zhang, MD, PhD, Professor, Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, No. 301 Yanchang Road, Shanghai 200072, China. yizshcn@gmail.com
Received: January 26, 2026 Revised: February 16, 2026 Accepted: May 9, 2026 Published online: June 26, 2026 Processing time: 143 Days and 21.5 Hours
Abstract
BACKGROUND
A simple method for evaluating renal function is the estimated glomerular filtration rate (eGFR), which reveals prognostic implications. However, it is not yet known which equation should be applied to elderly Chinese individuals.
AIM
To compare the ability of Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and the Asian/Chinese-modified equations and their predictive performance for clinical outcomes.
METHODS
A total of 3257 community-dwelling elderly Chinese participants (≥ 65 years) in northern Shanghai were prospectively recruited in the present study. The GFR was estimated by creatinine-based MDRD and CKD-EPI and modified Asian/Chinese (c-aMDRD, aCKD-EPI, and cCKD-EPI) equations. The outcomes included major adverse cardiovascular events (MACE), cardiovascular mortality, and all-cause mortality.
RESULTS
The prevalence of eGFR < 60 mL/minute, based on different eGFR equations, ranged from 5.7% (c-aMDRD) to 16.5% (cCKD-EPI). The rate and risk of adverse outcomes were higher in patients with eGFR < 60 mL/minute (P < 0.05). Low eGFR (< 60 mL/minute) estimated by the c-aMDRD equation was associated with MACE and cardiovascular mortality, whereas low eGFR (< 60 mL/minute) estimated by the MDRD, c-aMDRD, CKD-EPI, aCKD-EPI, and cCKD-EPI equations was associated with all-cause mortality. The CKD-EPI, aCKD-EPI, and cCKD-EPI equations demonstrated significantly better predictive abilities for outcomes than the MDRD and c-aMDRD equations.
CONCLUSION
eGFR is an independent predictor of long-term outcomes. When estimated by the c-aMDRD equation, eGFR predicts MACE and cardiovascular mortality, while all equations predict all-cause mortality. The CKD-EPI, aCKD-EPI, and cCKD-EPI equations might be better than MDRD and c-aMDRD for risk stratification in the elderly Chinese population.
Core Tip: For risk stratification in elderly Chinese adults, the choice of estimated glomerular filtration rate equation is crucial. This study finds that while the modified Chinese-abbreviated Modification of Diet in Renal Disease equation specifically predicts major adverse cardiovascular events and cardiovascular death, the newer Chronic Kidney Disease Epidemiology Collaboration and its Chinese-adjusted versions are superior overall, offering the best predictive power for all-cause mortality.
