creatinine; glomerular filtration rate; young adult
Abstract :
[en] [en] BACKGROUND: Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malmö Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated.
METHODS: We collected data (GFR) measured by clearance of an exogenous marker (reference method), serum creatinine, age and sex from 2366 young adults (aged between 18 and 25 years) both from Europe and the USA.
RESULTS: In the European cohorts (n = 1892), the bias (in mL/min/1.73 m²) was systematically better for the EKFC and r-LMR equations compared with the CKD-EPI equation [2.28, 95% confidence interval (1.59; 2.91), -2.50 (-3.85; -1.76), 17.41 (16.49; 18.47), respectively]. The percentage of estimated GFR within 30% of measured GFR (P30) was also better for EKFC and r-LMR equations compared with the CKD-EPI equation [84.4% (82.8; 86.0), 87.2% (85.7; 88.7) and 65.4% (63.3; 67.6), respectively]. In the US cohorts (n = 474), the bias for the EKFC and r-LMR equations was better than for the CKD-EPI equation in the non-Black population [0.97 (-1.69; 3.06), -2.62 (-5.14; -1.43) and 7.74 (5.97; 9.63), respectively], whereas the bias was similar in Black US individuals. P30 results were not different between the three equations in US cohorts. Analyses in sub-populations confirmed these results, except in individuals with high GFR levels (GFR ≥120 mL/min/1.73 m²) for whom the CKD-EPI equation might have a lower bias.
CONCLUSIONS: We demonstrated that both the EKFC and r-LMR creatinine-based equations have a better performance than the CKD-EPI equation in a young population. The only exception might be in patients with hyperfiltration.
Disciplines :
Urology & nephrology
Author, co-author :
Delanaye, Pierre ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale ; Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nimes, France
Derain-Dubourg, Laurence; Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
Björk, Jonas ; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden ; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
Courbebaisse, Marie; Physiology Department, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, INSERM U1151-CNRS UMR8253, Paris, France
Couzi, Lionel ; CHU de Bordeaux, Nephrologie - Transplantation - Dialyse, Université de Bordeaux, CNRS-UMR 5164 Immuno ConcEpT, Bordeaux, France
Gaillard, Francois ; AURAL, Association pour l'utilisation du rein artificiel dans la région lyonnaise, Lyon, France
Garrouste, Cyril; Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
Grubb, Anders ; Department of Clinical Chemistry, Skåne University Hospital, Lund University, Lund, Sweden
Hansson, Magnus; Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
Kamar, Nassim; Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR - BMT, University Paul Sabatier, Toulouse, France
Legendre, Christophe; Hôpital Necker, AP-HP & Université Paris Descartes, Paris, France
Littmann, Karin ; Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institute, Huddinge, Sweden
Mariat, Christophe; Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne, France
Rostaing, Lionel ; Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, Hôpital Michallon, CHU Grenoble-Alpes, Grenoble, France
Rule, Andrew D; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
Sundin, Per-Ola ; Karla Healthcare Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Bökenkamp, Arend; Department of Paediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Berg, Ulla; Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
Åsling-Monemi, Kajsa; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
Åkesson, Anna; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden ; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
Larsson, Anders ; Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
Nyman, Ulf; Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, 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
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