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Prospects for improved glomerular filtration rate estimation based on creatinine—results from a transnational multicentre study

Björk, Jonas (author)
Lund University,Lunds universitet,Centrum för ekonomisk demografi,Ekonomihögskolan,Avdelningen för arbets- och miljömedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,Kirurgi och folkhälsa,Forskargrupper vid Lunds universitet,EPI@LUND,Centre for Economic Demography,Lund University School of Economics and Management, LUSEM,Division of Occupational and Environmental Medicine, Lund University,Department of Laboratory Medicine,Faculty of Medicine,Surgery and public health,Lund University Research Groups
Nyman, Ulf (author)
Lund University,Lunds universitet,Diagnostisk radiologi, Malmö,Forskargrupper vid Lunds universitet,Radiology Diagnostics, Malmö,Lund University Research Groups
Courbebaisse, Marie (author)
Paris Descartes University
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Couzi, Lionel (author)
University of Bordeaux
Dalton, R Neil (author)
Evelina London Children's Healthcare
Dubourg, Laurence (author)
Hôpital Edouard Herriot
Ebert, Natalie (author)
Charité - University Medicine Berlin
Eriksen, Bjørn Odvar (author)
UiT The Arctic University of Norway, Tromsø
Gaillard, Francois (author)
Assistance Publique des Hôpitaux de Paris
Garrouste, Cyril (author)
Clermont-Ferrand University Hospital
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
Hansson, Magnus (author)
Karolinska Institutet
Jacquemont, Lola (author)
University of Nantes
Jones, Ian (author)
Örebro University,Örebro University Hospital
Kamar, Nassim (author)
Université Paul Sabatier
Lamb, Edmund J. (author)
Great Ormond Street Hospital
Legendre, Christophe (author)
Paris Descartes University
Littmann, Karin (author)
Karolinska Institutet
Mariat, Christophe (author)
Hopital Nord CHU de Sainte-Etienne
Melsom, Toralf (author)
UiT The Arctic University of Norway, Tromsø
Rostaing, Lionel (author)
Grenoble University Hospital
Rule, Andrew D. (author)
Mayo Clinic Minnesota
Schaeffner, Elke (author)
Charité - University Medicine Berlin
Sundin, Per-Ola (author)
Örebro University
Turner, Stephen (author)
Mayo Clinic Minnesota
Åkesson, Anna (author)
Lund University,Lunds universitet,Avdelningen för arbets- och miljömedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,EPI@LUND,Forskargrupper vid Lunds universitet,Division of Occupational and Environmental Medicine, Lund University,Department of Laboratory Medicine,Faculty of Medicine,Lund University Research Groups,Kliniska Studier Sverige, Forum söder
Delanaye, Pierre (author)
University of Liège Hospital,University of Liège
Pottel, Hans (author)
Catholic University of Leuven
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 (creator_code:org_t)
2020-06-13
2020
English 10 s.
In: Clinical Kidney Journal. - : Oxford University Press (OUP). - 2048-8505 .- 2048-8513. ; 13:4, s. 674-683
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved.MethodsIn a cross-sectional analysis covering the years 2003–17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund–Malmö revised equation (LMR) and the Full Age Spectrum equation.Results7In patients aged 18–39 years old, CKD-EPI overestimated GFR with 5.0–16 mL/min/1.73 m2 in median in both cohort types at mGFR levels <120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%.ConclusionsNone of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

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