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New creatinine- and...
New creatinine- and cystatin C-based equations to estimate GFR without race
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- Inker, Lesley A. (author)
- Tufts University
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- Eneanya, Nwamaka D (author)
- University of Pennsylvania
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- Coresh, Josef (author)
- Johns Hopkins University
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- Tighiouart, Hocine (author)
- Tufts University
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- Wang, Dan (author)
- Johns Hopkins University
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- Sang, Yingying (author)
- Johns Hopkins University
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- Crews, Deidra C (author)
- Johns Hopkins University
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- Doria, Alessandro (author)
- Joslin Diabetes Center
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- Estrella, Michelle M (author)
- University of California, San Francisco
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- Froissart, Marc (author)
- Lausanne University Hospital
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- Grams, Morgan E (author)
- Johns Hopkins University
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- Greene, Tom (author)
- University of Utah Health Care
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- Grubb, Anders (author)
- Lund University,Lunds universitet,Cystatin C, njursjukdom, amyloidos och antibiotika,Forskargrupper vid Lunds universitet,Cystatin C, renal disease, amyloidosis and antibiotics,Lund University Research Groups
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- Gudnason, Vilmundur (author)
- Icelandic Heart Association,University of Iceland
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- Gutierrez, Orlando M (author)
- University of Alabama
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- Kalil, Roberto (author)
- University of Maryland
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- Karger, Amy B (author)
- University of Minnesota
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- Mauer, Michael (author)
- University of Minnesota
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- Navis, Gerjan (author)
- University Medical Center Groningen
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- Nelson, Robert G (author)
- National institutes of Health, Phoenix
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- Poggio, Emilio D (author)
- Cleveland Clinic Foundation
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- Rodby, Roger (author)
- Rush University Medical Center Chicago
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- Rossing, Peter (author)
- Steno Diabetes Center Copenhagen,University of Copenhagen
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- Rule, Andrew D. (author)
- Mayo Clinic Minnesota
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- Selvin, Elizabeth (author)
- Johns Hopkins University
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- Seegmiller, Jesse C (author)
- University of Minnesota
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- Shlipak, Michael G. (author)
- University of California, San Francisco
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- Torres, Vicente E (author)
- Mayo Clinic Minnesota
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- Yang, Wei (author)
- University of Pennsylvania
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- Ballew, Shoshana H. (author)
- Johns Hopkins University
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- Couture, Sara J (author)
- Tufts University
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- Powe, Neil R (author)
- University of California, San Francisco
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- Levey, Andrew S. (author)
- Tufts University
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(creator_code:org_t)
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- 2021
- 2021
- English.
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In: New England Journal of Medicine. - 0028-4793. ; 385:19, s. 1737-1749
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http://dx.doi.org/10...
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Abstract
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- Background: Current equations for estimated glomerular filtration rate (eGFR) that use serum creatinine or cystatin C incorporate age, sex, and race to estimate measured GFR. However, race in eGFR equations is a social and not a biologic construct.Methods: We developed new eGFR equations without race using data from two development data sets: 10 studies (8254 participants, 31.5% Black) for serum creatinine and 13 studies (5352 participants, 39.7% Black) for both serum creatinine and cystatin C. In a validation data set of 12 studies (4050 participants, 14.3% Black), we compared the accuracy of new eGFR equations to measured GFR. We projected the prevalence of chronic kidney disease (CKD) and GFR stages in a sample of U.S. adults, using current and new equations.Results: In the validation data set, the current creatinine equation that uses age, sex, and race overestimated measured GFR in Blacks (median, 3.7 ml per minute per 1.73 m2 of body-surface area; 95% confidence interval [CI], 1.8 to 5.4) and to a lesser degree in non-Blacks (median, 0.5 ml per minute per 1.73 m2; 95% CI, 0.0 to 0.9). When the adjustment for Black race was omitted from the current eGFR equation, measured GFR in Blacks was underestimated (median, 7.1 ml per minute per 1.73 m2; 95% CI, 5.9 to 8.8). A new equation using age and sex and omitting race underestimated measured GFR in Blacks (median, 3.6 ml per minute per 1.73 m2; 95% CI, 1.8 to 5.5) and overestimated measured GFR in non-Blacks (median, 3.9 ml per minute per 1.73 m2; 95% CI, 3.4 to 4.4). For all equations, 85% or more of the eGFRs for Blacks and non-Blacks were within 30% of measured GFR. New creatinine-cystatin C equations without race were more accurate than new creatinine equations, with smaller differences between race groups. As compared with the current creatinine equation, the new creatinine equations, but not the new creatinine-cystatin C equations, increased population estimates of CKD prevalence among Blacks and yielded similar or lower prevalence among non-Blacks.Conclusions: New eGFR equations that incorporate creatinine and cystatin C but omit race are more accurate and led to smaller differences between Black participants and non-Black participants than new equations without race with either creatinine or cystatin C alone.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Inker, Lesley A.
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Eneanya, Nwamaka ...
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Coresh, Josef
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Tighiouart, Hoci ...
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Wang, Dan
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Sang, Yingying
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show more...
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Crews, Deidra C
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Doria, Alessandr ...
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Estrella, Michel ...
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Froissart, Marc
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Grams, Morgan E
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Greene, Tom
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Grubb, Anders
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Gudnason, Vilmun ...
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Gutierrez, Orlan ...
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Kalil, Roberto
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Karger, Amy B
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Mauer, Michael
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Navis, Gerjan
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Nelson, Robert G
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Poggio, Emilio D
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Rodby, Roger
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Rossing, Peter
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Rule, Andrew D.
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Selvin, Elizabet ...
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Seegmiller, Jess ...
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Shlipak, Michael ...
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Torres, Vicente ...
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Yang, Wei
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Ballew, Shoshana ...
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Couture, Sara J
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Powe, Neil R
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Levey, Andrew S.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Urology and Neph ...
- Articles in the publication
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New England Jour ...
- By the university
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Lund University