CKD-EPI and EKFC GFR Estimating Equations: Performance and Other Considerations for Selecting Equations for Implementation in Adults

• Background: New CKD-EPI and EKFC estimated GFR (eGFR) equations usingcreatinine (eGFRcr), cystatin C (eGFRcys) and both (eGFRcr-cys) have sufficientaccuracy for use in clinical practice. A better understanding of the equations, includingtheir performance in race, sex and age subgroups, is important for selection of eGFRequations for global implementation.Methods: We evaluated performance (bias and P30) of equations and methods usedfor equation development in an independent study population comprising 4050participants pooled from 12 studies. The mean (SD) mGFR was 76.4 (29.6)ml/min/1.73 m2, age 57.0 (17.4) years, with 1557 (38%) women and 579 (14%) Blackparticipants.Results: Coefficients for creatinine, cystatin C, age and sex in the CKD-EPI and EKFCequations are similar. Performance of the eGFRcr-cys equations in the overallpopulation (bias 90%) was better than the eGFRcr oreGFRcys equations, with fewer differences among race, sex and age subgroups.Differences in performance across subgroups reflected differences in diversity ofsource populations and use of variables for race and sex for equation development.Larger differences among eGFRcr equations reflected regional population differencesin non-GFR determinants of creatinine.Conclusion: CKD-EPI and EKFC equations are approaching convergence. It is notpossible to maximize both accuracy and uniformity in selecting one of the currentlyavailable eGFRcr equations for implementation across regions. Decisions shouldconsider methods for equation development in addition to performance. Wider use ofcystatin C with creatinine could maximize both accuracy and uniformity of GFRestimation using currently available equations.

Subject headings

NATURVETENSKAP  -- Matematik -- Beräkningsmatematik (hsv//swe)

NATURAL SCIENCES  -- Mathematics -- Computational Mathematics (hsv//eng)

NATURVETENSKAP  -- Biologi -- Evolutionsbiologi (hsv//swe)

NATURAL SCIENCES  -- Biological Sciences -- Evolutionary Biology (hsv//eng)

Publication and Content Type

art (subject category)

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