Rescaling creatinine makes GFR estimation equations generally applicable across populations - Validation results for the Lund-Malmö equation in a French cohort of sub-Saharan ancestry
(2024) In Clinical Chemistry and Laboratory Medicine 62(3). p.421-427- Abstract
To make glomerular filtration rate (GFR) estimating equations applicable across populations with different creatinine generation by using rescaled serum creatinine (sCr/Q) where sCr represents the individual creatinine level and Q the average creatinine value in healthy persons of the same population. GFR measurements (mGFR, plasma clearance of 51Cr-EDTA) were conducted in 964 adult Black Europeans. We established the re-expressed Lund-Malmö revised equation (r-LMR) by replacing serum creatinine (sCr) with rescaled creatinine sCr/Q. We evaluated the r-LMR equation based on Q-values of White Europeans (r-LMRQ-white; Q-values females: 62 μmol/L, males: 80 μmol/L) and Black Europeans (r-LMRQ-Black; Q-values females: 65 μmol/L, males: 90... (More)
To make glomerular filtration rate (GFR) estimating equations applicable across populations with different creatinine generation by using rescaled serum creatinine (sCr/Q) where sCr represents the individual creatinine level and Q the average creatinine value in healthy persons of the same population. GFR measurements (mGFR, plasma clearance of 51Cr-EDTA) were conducted in 964 adult Black Europeans. We established the re-expressed Lund-Malmö revised equation (r-LMR) by replacing serum creatinine (sCr) with rescaled creatinine sCr/Q. We evaluated the r-LMR equation based on Q-values of White Europeans (r-LMRQ-white; Q-values females: 62 μmol/L, males: 80 μmol/L) and Black Europeans (r-LMRQ-Black; Q-values females: 65 μmol/L, males: 90 μmol/L), and the European Kidney Function Consortium equation (EKFCQ-White and EKFCQ-Black) regarding bias, precision (interquartile range, IQR) and accuracy (percentage of estimates within ±10 % [P10] and ±30 % [P30] of mGFR). Median bias of r-LMRQ-White/r-LMRQ-Black/EKFCQ-White/EKFCQ-Black were -9.1/-4.5/-6.3/-0.9 mL/min/1.73 m2, IQR 14.7/14.5/14.5/15.6 mL/min/1.73 m2, P10 25.1 %/34.8 %/30.3 %/37.2 % and P30 74.2 %/84.1 %/80.6 %/83.6 %. The improvement of bias and accuracy when using proper Q-values was most pronounced in men. Similar improvements were obtained above and below mGFR 60 mL/min/1.73 m2 and at various age and BMI intervals, except for BMI<20 kg/m2 where bias increased, and accuracy decreased. GFR estimating equations may be re-expressed to include rescaled creatinine (sCr/Q) and used across populations with different creatinine generation if population-specific average creatinine concentrations (Q-values) for healthy persons are established.
(Less)
- author
- Nyman, Ulf LU ; Björk, Jonas LU ; Delanaye, Pierre ; Lahens, Alexandre ; Pottel, Hans ; Vidal-Petiot, Emmanuelle and Flamant, Martin
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- chronic kidney disease, creatinine, glomerular filtration rate, kidney function tests
- in
- Clinical Chemistry and Laboratory Medicine
- volume
- 62
- issue
- 3
- pages
- 7 pages
- publisher
- De Gruyter
- external identifiers
-
- pmid:37768854
- scopus:85173225892
- ISSN
- 1434-6621
- DOI
- 10.1515/cclm-2023-0496
- language
- English
- LU publication?
- yes
- id
- fc36ef5b-7093-41b8-a938-bd8b359a0ae3
- date added to LUP
- 2023-12-19 15:08:53
- date last changed
- 2025-01-27 15:09:46
@article{fc36ef5b-7093-41b8-a938-bd8b359a0ae3,
abstract = {{<p>To make glomerular filtration rate (GFR) estimating equations applicable across populations with different creatinine generation by using rescaled serum creatinine (sCr/Q) where sCr represents the individual creatinine level and Q the average creatinine value in healthy persons of the same population. GFR measurements (mGFR, plasma clearance of 51Cr-EDTA) were conducted in 964 adult Black Europeans. We established the re-expressed Lund-Malmö revised equation (r-LMR) by replacing serum creatinine (sCr) with rescaled creatinine sCr/Q. We evaluated the r-LMR equation based on Q-values of White Europeans (r-LMRQ-white; Q-values females: 62 μmol/L, males: 80 μmol/L) and Black Europeans (r-LMRQ-Black; Q-values females: 65 μmol/L, males: 90 μmol/L), and the European Kidney Function Consortium equation (EKFCQ-White and EKFCQ-Black) regarding bias, precision (interquartile range, IQR) and accuracy (percentage of estimates within ±10 % [P10] and ±30 % [P30] of mGFR). Median bias of r-LMRQ-White/r-LMRQ-Black/EKFCQ-White/EKFCQ-Black were -9.1/-4.5/-6.3/-0.9 mL/min/1.73 m2, IQR 14.7/14.5/14.5/15.6 mL/min/1.73 m2, P10 25.1 %/34.8 %/30.3 %/37.2 % and P30 74.2 %/84.1 %/80.6 %/83.6 %. The improvement of bias and accuracy when using proper Q-values was most pronounced in men. Similar improvements were obtained above and below mGFR 60 mL/min/1.73 m2 and at various age and BMI intervals, except for BMI<20 kg/m2 where bias increased, and accuracy decreased. GFR estimating equations may be re-expressed to include rescaled creatinine (sCr/Q) and used across populations with different creatinine generation if population-specific average creatinine concentrations (Q-values) for healthy persons are established.</p>}},
author = {{Nyman, Ulf and Björk, Jonas and Delanaye, Pierre and Lahens, Alexandre and Pottel, Hans and Vidal-Petiot, Emmanuelle and Flamant, Martin}},
issn = {{1434-6621}},
keywords = {{chronic kidney disease; creatinine; glomerular filtration rate; kidney function tests}},
language = {{eng}},
number = {{3}},
pages = {{421--427}},
publisher = {{De Gruyter}},
series = {{Clinical Chemistry and Laboratory Medicine}},
title = {{Rescaling creatinine makes GFR estimation equations generally applicable across populations - Validation results for the Lund-Malmö equation in a French cohort of sub-Saharan ancestry}},
url = {{http://dx.doi.org/10.1515/cclm-2023-0496}},
doi = {{10.1515/cclm-2023-0496}},
volume = {{62}},
year = {{2024}},
}