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Publication Information
Affiliation
1Department of Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium
2Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
3Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
4Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
5Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, Liège, Belgium
6Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
7Department of Laboratory Medicine and Pathology, Kidney Research Institute, Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, WA, USA
8Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
9Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
10Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
11Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
Authors
Björk J, Cavalier E, Delanaye P, Hoofnagle AN, Nyman U, Pottel H, Rule AD, Schaeffner E, Shi J
Studies
Abstract
The new creatinine-based European Kidney Function Consortium (EKFC) is used to estimate glomerular filtration rate (GFR). This equation has been developed and validated mainly in European subjects. This equation is based on 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 Black and non-Black Americans. In this cross-sectional analysis, we included 12,854 participants from 9 studies 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 bias (0.14 95%CI[-0.07;0.35] mL/min/1.73m²), and the statistical bias of the EKFCRF (0.74 95%CI[0.51;0.94] mL/min/1.73m²) was closer to zero than that of the CKD-EPI2021 equation (1.22 95%CI[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 with the EKFCPS equation (81.1% [80.5%-81.8%]). The EKFC-equation can be used to estimate GFR in the USA incorporating either self-reported race or unknown race at the patient’s discretion per hospital registration records.