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Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil and Africa

Delanaye, Pierre ; Vidal-Petiot, Emmanuelle ; Björk, Jonas LU ; Ebert, Natalie ; Eriksen, Björn O. ; Dubourg, Laurence ; Grubb, Anders LU orcid ; Hansson, Magnus ; Littmann, Karin and Mariat, Christophe , et al. (2023) In Nephrology Dialysis Transplantation 38(1). p.106-118
Abstract

Background: A new Chronic Kidney Disease Epidemiology Collaboration equation without the race variable has been recently proposed (CKD-EPIAS). This equation has neither been validated outside USA nor compared with the new European Kidney Function Consortium (EKFC) and Lund-Malmö Revised (LMREV) equations, developed in European cohorts. Methods: Standardized creatinine and measured glomerular filtration rate (GFR) from the European EKFC cohorts (n = 13 856 including 6031 individuals in the external validation cohort), from France (n = 4429, including 964 Black Europeans), from Brazil (n = 100) and from Africa (n = 508) were used to test the performances of the equations. A matched analysis between White Europeans and Black Africans or... (More)

Background: A new Chronic Kidney Disease Epidemiology Collaboration equation without the race variable has been recently proposed (CKD-EPIAS). This equation has neither been validated outside USA nor compared with the new European Kidney Function Consortium (EKFC) and Lund-Malmö Revised (LMREV) equations, developed in European cohorts. Methods: Standardized creatinine and measured glomerular filtration rate (GFR) from the European EKFC cohorts (n = 13 856 including 6031 individuals in the external validation cohort), from France (n = 4429, including 964 Black Europeans), from Brazil (n = 100) and from Africa (n = 508) were used to test the performances of the equations. A matched analysis between White Europeans and Black Africans or Black Europeans was performed. Results: In White Europeans (n = 9496), both the EKFC and LMREV equations outperformed CKD-EPIAS (bias of -0.6 and -3.2, respectively versus 5.0 mL/min/1.73 m², and accuracy within 30% of 86.9 and 87.4, respectively, versus 80.9%). In Black Europeans and Black Africans, the best performance was observed with the EKFC equation using a specific Q-value (= concentration of serum creatinine in healthy males and females). These results were confirmed in matched analyses, which showed that serum creatinine concentrations were different in White Europeans, Black Europeans and Black Africans for the same measured GFR, age, sex and body mass index. Creatinine differences were more relevant in males. Conclusion: In a European and African cohort, the performances of CKD-EPIAS remain suboptimal. The EKFC equation, using usual or dedicated population-specific Q-values, presents the best performance in the whole age range in the European and African populations included in this study.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
creatinine, glomerular filtration rate, race
in
Nephrology Dialysis Transplantation
volume
38
issue
1
pages
13 pages
publisher
Oxford University Press
external identifiers
  • pmid:36002032
  • scopus:85141209736
ISSN
0931-0509
DOI
10.1093/ndt/gfac241
language
English
LU publication?
yes
additional info
Funding Information: ACKNOWLEDGEMENTS We are grateful to all participating patients who gave consent and to study nurses, who contributed to the clinical studies that make part of this data collection. We thank Rodolphe Ahmed, Head of the Medical Center of Kinshasa, and Jacques Sissoko, Director of SAMU-CI, for giving us the framework with the necessary tools to ensure the iohexol procedure in Kinshasa and in Abidjan, respectively. We thank Edmund Lamb (Clinical Biochemist, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK) for allowing us to use the data from Kent. Hans Pottel, Jonas Björk, Natalie Ebert, Björn O. Eriksen, Laurence Dubourg, Anders Grubb, Christophe Mariat, Toralf Melsom, Andrew D. Rule, Elke Schaeffner, Arend Bökenkamp, Etienne Cavalier, Ulf Nyman, Marie Courbebaisse, François Gaillard, Martin Flamant and Pierre Delanaye are members of the European Kidney Function Consortium. Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press on behalf of the ERA.
id
798f70cf-247f-4d0c-8295-72ea55657ef4
date added to LUP
2024-01-11 14:22:03
date last changed
2024-04-12 08:45:10
@article{798f70cf-247f-4d0c-8295-72ea55657ef4,
  abstract     = {{<p>Background: A new Chronic Kidney Disease Epidemiology Collaboration equation without the race variable has been recently proposed (CKD-EPIAS). This equation has neither been validated outside USA nor compared with the new European Kidney Function Consortium (EKFC) and Lund-Malmö Revised (LMREV) equations, developed in European cohorts. Methods: Standardized creatinine and measured glomerular filtration rate (GFR) from the European EKFC cohorts (n = 13 856 including 6031 individuals in the external validation cohort), from France (n = 4429, including 964 Black Europeans), from Brazil (n = 100) and from Africa (n = 508) were used to test the performances of the equations. A matched analysis between White Europeans and Black Africans or Black Europeans was performed. Results: In White Europeans (n = 9496), both the EKFC and LMREV equations outperformed CKD-EPIAS (bias of -0.6 and -3.2, respectively versus 5.0 mL/min/1.73 m², and accuracy within 30% of 86.9 and 87.4, respectively, versus 80.9%). In Black Europeans and Black Africans, the best performance was observed with the EKFC equation using a specific Q-value (= concentration of serum creatinine in healthy males and females). These results were confirmed in matched analyses, which showed that serum creatinine concentrations were different in White Europeans, Black Europeans and Black Africans for the same measured GFR, age, sex and body mass index. Creatinine differences were more relevant in males. Conclusion: In a European and African cohort, the performances of CKD-EPIAS remain suboptimal. The EKFC equation, using usual or dedicated population-specific Q-values, presents the best performance in the whole age range in the European and African populations included in this study.</p>}},
  author       = {{Delanaye, Pierre and Vidal-Petiot, Emmanuelle and Björk, Jonas and Ebert, Natalie and Eriksen, Björn O. and Dubourg, Laurence and Grubb, Anders and Hansson, Magnus and Littmann, Karin and Mariat, Christophe and Melsom, Toralf and Schaeffner, Elke and Sundin, Per Ola and Bökenkamp, Arend and Berg, Ulla B. and Åsling-Monemi, Kajsa and Åkesson, Anna and Larsson, Anders and Cavalier, Etienne and Dalton, R. Neil and Courbebaisse, Marie and Couzi, Lionel and Gaillard, Francois and Garrouste, Cyril and Jacquemont, Lola and Kamar, Nassim and Legendre, Christophe and Rostaing, Lionel and Stehl, Thomas and Haymann, Jean Philippe and Selistre, Luciano Da Silva and Strogoff-De-Matos, Jorge P. and Bukabau, Justine B. and Sumaili, Ernest K. and Yayo, Eric and Monnet, Dagui and Nyman, Ulf and Pottel, Hans and Flamant, Martin}},
  issn         = {{0931-0509}},
  keywords     = {{creatinine; glomerular filtration rate; race}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  pages        = {{106--118}},
  publisher    = {{Oxford University Press}},
  series       = {{Nephrology Dialysis Transplantation}},
  title        = {{Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil and Africa}},
  url          = {{http://dx.doi.org/10.1093/ndt/gfac241}},
  doi          = {{10.1093/ndt/gfac241}},
  volume       = {{38}},
  year         = {{2023}},
}