[en] Estimating glomerular filtration rate (GFR) is important in daily practice to assess kidney function and adapting the best clinical care of patients with and without chronic kidney disease. The new creatinine-based European Kidney Function Consortium (EKFC) equation is used to estimate GFR. This equation was developed and validated mainly in European individuals and based on a rescaled creatinine, with the rescaling factor (Q-value) defined as the median normal value of serum creatinine in a given population. The validation was limited in Non-Black Americans and absent in Black Americans. Here, our cross-sectional analysis included 12,854 participants from nine studies encompassing large numbers of both non-Black and Black with measured GFR by clearance of an exogenous marker (reference method), serum creatinine, age, sex, and self-reported race available. Two strategies were considered with population-specific Q-values in Black and non-Black men and women (EKFCPS) or a race-free Q-value (EKFCRF). In the whole population, only the EKFCPS equation showed no statistical median bias (0.14, 95% confidence interval [-0.07; 0.35] mL/min/1.73m2), and the bias for the EKFCRF (0.74, [0.51; 0.94] mL/min/1.73m2) was closer to zero than that for the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI2021) equation (1.22, [0.99; 1.47]) mL/min/1.73m2]. The percentage of estimated GFR within 30% of measured GFR was similar for CKD-EPI2021 (79.2% [78.5%; 79.9%]) and EKFCRF (80.1% [79.4%; 80.7%]), but improved for the EKFCPS equation (81.1% [80.5%; 81.8%]). Thus, our EKFC equations can be used to estimate GFR in the United States incorporating either self-reported race or unknown race at the patient's discretion per hospital registration records.
Disciplines :
Urology & nephrology
Author, co-author :
Delanaye, Pierre ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Rule, Andrew D; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
Schaeffner, Elke; Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Shi, Junyan; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
Hoofnagle, Andrew N; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA, Kidney Research Institute, Department of Medicine, University of Washington, Seattle, Washington, USA, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, Washington, USA, Department of Medicine, University of Washington, Seattle, Washington, USA
Nyman, Ulf; Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
Björk, Jonas; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden, Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
Pottel, Hans ; Université de Liège - ULiège > Département des sciences cliniques ; Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
Language :
English
Title :
Performance of the European Kidney Function Consortium (EKFC) creatinine-based equation in United States cohorts.
Sverige Vetenskapsrådet NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases
Funding text :
The Assessing Long Term Outcomes in Living Kidney Donors, Chronic Renal Insufficiency Cohort, Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications, Preventing Early Renal Loss in Diabetes, African American Study of Kidney Disease and Hypertension, and Modified Diet in Renal Disease studies were performed by respective investigators and supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The data from these studies reported here were supplied by the NIDDK Central Repository. This manuscript was not prepared in collaboration with the investigators of the different studies and does not necessarily reflect the opinions or views of these studies, the NIDDK Central Repository, or the NIDDK. This study was supported by the Swedish Research Council (Vetenskapsrådet; grant no. 2019-00198). JB has received funding from the Swedish Research Council (VR) to conduct large-scale epidemiological studies linked with registered data from health care. This funding source was not at all involved in design, analysis, presentation, or interpretation of the results from the present study.This study was supported by the Swedish Research Council (Vetenskapsrådet; grant no. 2019-00198). JB has received funding from the Swedish Research Council (VR) to conduct large-scale epidemiological studies linked with registered data from health care. This funding source was not at all involved in design, analysis, presentation, or interpretation of the results from the present study.
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