Extending the Lund-Malmö creatinine-based GFR equation to cystatin C - validation results from the European Kidney Function Consortium (EKFC) cohort of children and adults.
Björk, Jonas; Nyman, Ulf; Berg, Ullaet al.
2024 • In Scandinavian Journal of Clinical and Laboratory Investigation, 84 (7-8), p. 577-583
[en] The aim of the present study was to extend the creatinine-based Lund-Malmö GFR equation for use with rescaled cystatin C (r-LMRCys) and validate it against measured GFR (mGFR) in the EKFC cystatin C cohort of children (n = 2,293) and adults (n = 7,727). Rescaling was obtained by dividing each biomarker by a Q-value, representing the population-specific median biomarker level among healthy individuals. Validation included median bias/precision/accuracy (percent estimates within ±30% of mGFR, P30). Performance was compared with the EKFC-equation (EKFCCys), the CAPA cystatin C equation, the corresponding equations based on rescaled creatinine (r-LMRCr and EKFCCr) and the arithmetic mean of r-LMRCr and CAPA (r-LMRCr+CAPA), r-LMRCr and r-LMRCys (r-LMRMean), and EKFCCr and EKFCCys (EKFCMean). The overall P30 of r-LMRCys in adults was 86.2% (95% CI 85.4%-86.9%), which was 6.6 percentage points (pp; 95% CI 5.8-7.4 pp) higher than for CAPA and similar to r-LMRCr (P30 87.4%, 95% CI 86.6%-88.1%). r-LMRCys and EKFCCys exhibited similar performance both overall and across subgroups of age, sex, GFR and BMI and in children. All three arithmetic mean equations had similar P30-accuracy and generally performed better than the corresponding single-marker equations. Our results show that the Lund-Malmö GFR equation can be adapted for use with rescaled cystatin C with performance that is similar to the best-performing equations based on rescaled creatinine. The generality of the applied biomarker rescaling principle implies that the future demand for population- and biomarker-specific GFR estimating equations can be expected to decrease substantially.
Disciplines :
Urology & nephrology
Author, co-author :
Björk, Jonas ; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden ; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
Nyman, Ulf ; Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
Berg, Ulla; Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
Bökenkamp, Arend ; Department of Paediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, Amsterdam, the Netherlands
Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Ebert, Natalie ; Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
Eriksen, Björn O ; Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
Derain Dubourg, Laurence ; Nephrologie, Dialyse, Hypertension et Exploration Fonctionnelle Renale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, and Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, Lyon, France
Goffin, Karolien ; Department of Nuclear Medicine & Molecular Imaging, University Hospital Leuven, Leuven, Belgium
Grubb, Anders ; Department of Clinical Chemistry, Skåne University Hospital, Lund, Lund University, Sweden
Hansson, Magnus ; Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Karolinska Institute, Huddinge, Sweden
Larsson, Anders ; Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
Lemoine, Sandrine ; Nephrologie, Dialyse, Hypertension et Exploration Fonctionnelle Renale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, IRIS Team, France
Littmann, Karin ; Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
Mariat, Christophe ; Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital Nord, CHU de Saint-Etienne, France
Melsom, Toralf ; Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
Schaeffner, Elke ; Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
Sundin, Per-Ola ; Karla Healthcare Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Åsling-Monemi, Kajsa; Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
Delanaye, Pierre ; Université de Liège - ULiège > Département des sciences cliniques > Néphrologie ; Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
Pottel, Hans ; Université de Liège - ULiège > Département des sciences cliniques ; Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
Extending the Lund-Malmö creatinine-based GFR equation to cystatin C - validation results from the European Kidney Function Consortium (EKFC) cohort of children and adults.
Publication date :
08 January 2024
Journal title :
Scandinavian Journal of Clinical and Laboratory Investigation
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