Performance of the European Kidney Function Consortium (EKFC) creatinine-based equation in United States cohorts
(2024) In Kidney International 105(3). p.629-637- Abstract
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 Americans... (More)
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 Americans 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.
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- author
- Delanaye, Pierre ; Rule, Andrew D. ; Schaeffner, Elke ; Cavalier, Etienne ; Shi, Junyan ; Hoofnagle, Andrew N. ; Nyman, Ulf LU ; Björk, Jonas LU and Pottel, Hans
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- chronic kidney disease, glomerular filtration rate, serum creatinine
- in
- Kidney International
- volume
- 105
- issue
- 3
- pages
- 9 pages
- publisher
- Nature Publishing Group
- external identifiers
-
- pmid:38101514
- scopus:85184784028
- ISSN
- 0085-2538
- DOI
- 10.1016/j.kint.2023.11.024
- language
- English
- LU publication?
- yes
- id
- 03dced2e-f032-463b-aef3-84e3069c30d1
- date added to LUP
- 2024-02-28 15:24:01
- date last changed
- 2024-04-13 12:04:44
@article{03dced2e-f032-463b-aef3-84e3069c30d1,
abstract = {{<p>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 Americans 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 (EKFC<sub>PS</sub>) or a race-free Q-value (EKFC<sub>RF</sub>). In the whole population, only the EKFC<sub>PS</sub> equation showed no statistical median bias (0.14, 95% confidence interval [-0.07; 0.35] mL/min/1.73m<sup>2</sup>), and the bias for the EKFC<sub>RF</sub> (0.74, [0.51; 0.94] mL/min/1.73m<sup>2</sup>) was closer to zero than that for the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI<sub>2021</sub>) equation (1.22, [0.99; 1.47]) mL/min/1.73m<sup>2</sup>]. The percentage of estimated GFR within 30% of measured GFR was similar for CKD-EPI<sub>2021</sub> (79.2% [78.5%; 79.9%]) and EKFC<sub>RF</sub> (80.1% [79.4%; 80.7%]), but improved for the EKFC<sub>PS</sub> 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.</p>}},
author = {{Delanaye, Pierre and Rule, Andrew D. and Schaeffner, Elke and Cavalier, Etienne and Shi, Junyan and Hoofnagle, Andrew N. and Nyman, Ulf and Björk, Jonas and Pottel, Hans}},
issn = {{0085-2538}},
keywords = {{chronic kidney disease; glomerular filtration rate; serum creatinine}},
language = {{eng}},
number = {{3}},
pages = {{629--637}},
publisher = {{Nature Publishing Group}},
series = {{Kidney International}},
title = {{Performance of the European Kidney Function Consortium (EKFC) creatinine-based equation in United States cohorts}},
url = {{http://dx.doi.org/10.1016/j.kint.2023.11.024}},
doi = {{10.1016/j.kint.2023.11.024}},
volume = {{105}},
year = {{2024}},
}