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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

Nyman, Ulf LU ; Björk, Jonas LU ; Delanaye, Pierre ; Lahens, Alexandre ; Pottel, Hans ; Vidal-Petiot, Emmanuelle and Flamant, Martin (2023) In Clinical Chemistry and Laboratory Medicine
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.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
chronic kidney disease, creatinine, glomerular filtration rate, kidney function tests
in
Clinical Chemistry and Laboratory Medicine
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
2024-04-18 01:20:25
@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&lt;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}},
  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}},
  year         = {{2023}},
}