Accuracy of the New Creatinine-based Equations for Estimating Glomerular Filtration Rate in Koreans
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background: New creatinine-based estimated glomerular filtration rate (eGFR) equations, including the 2021 Chronic Kidney Disease Epidemiology Collaboration (2021 CKD-EPI) and European Kidney Function Consortium (EKFC) equations, have been introduced recently. We assessed the performance of the 2021 CKD-EPI and EKFC equations in the Korean population. Methods: We analyzed 1,654 Korean patients aged ≥18 years who underwent chromium-51-ethylenediamine tetraacetic acid GFR measurements (mGFR). Bias (eGFR–mGFR), root mean square error (RMSE), and proportion of eGFR within 30% of mGFR (P30) of the 2009 CKD-EPI, 2021 CKD-EPI, and EFKC equations were compared. The concordance rate between eGFR and mGFR categories was evaluated. Both eGFR and mGFR categories were classified into six groups: ≥90, 89–60, 59–45, 44–30, 29–15, and <15 mL/min/1.73 m2. Results: The median bias (mL/min/1.73 m2) was 1.8 for the 2009 CKD-EPI equation, 4.8 for the 2021 CKD-EPI equation, and –0.3 for the EKFC equation. The P30 and RMSE were 78.2% and 17.0 for the 2009 CKD-EPI equation, 75.6% and 17.4 for the 2021 CKD-EPI equation, and 80.0% and 16.7 for the EKFC equation, respectively. The overall GFR category concordance rate between eGFR and mGFR was 63.4% for the 2009 CKD-EPI equation, 60.5% for the 2021 CKD-EPI equation, and 61.0% for the EKFC equation. Conclusions: Among the three eGFR equations, the EKFC equation had the smallest bias and highest P30 in Koreans. The 2009 CKD-EPI equation had a lower bias than the 2021 CKD-EPI equation.
Abstract
Background: New creatinine-based estimated glomerular filtration rate (eGFR) equations, including the 2021 Chronic Kidney Disease Epidemiology Collaboration (2021 CKD-EPI) and European Kidney Function Consortium (EKFC) equations, have been introduced recently. We assessed the performance of the 2021 CKD-EPI and EKFC equations in the Korean population. Methods: We analyzed 1,654 Korean patients aged ≥18 years who underwent chromium-51-ethylenediamine tetraacetic acid GFR measurements (mGFR). Bias (eGFR–mGFR), root mean square error (RMSE), and proportion of eGFR within 30% of mGFR (P30) of the 2009 CKD-EPI, 2021 CKD-EPI, and EFKC equations were compared. The concordance rate between eGFR and mGFR categories was evaluated. Both eGFR and mGFR categories were classified into six groups: ≥90, 89–60, 59–45, 44–30, 29–15, and <15 mL/min/1.73 m2. Results: The median bias (mL/min/1.73 m2) was 1.8 for the 2009 CKD-EPI equation, 4.8 for the 2021 CKD-EPI equation, and –0.3 for the EKFC equation. The P30 and RMSE were 78.2% and 17.0 for the 2009 CKD-EPI equation, 75.6% and 17.4 for the 2021 CKD-EPI equation, and 80.0% and 16.7 for the EKFC equation, respectively. The overall GFR category concordance rate between eGFR and mGFR was 63.4% for the 2009 CKD-EPI equation, 60.5% for the 2021 CKD-EPI equation, and 61.0% for the EKFC equation. Conclusions: Among the three eGFR equations, the EKFC equation had the smallest bias and highest P30 in Koreans. The 2009 CKD-EPI equation had a lower bias than the 2021 CKD-EPI equation.
참고문헌 (30)
- Inker LA, "New creatinine-and cystatin C-based equations to estimate GFR without race", N Engl J Med, 385, pp.1737~1749 (2021)
- Stevens LA, "Assessing kidney function—measured and estimated glomerular filtration rate", N Engl J Med, 354, pp.2473~2483 (2006)
- Levey AS, "Strengths and limitations of estimated and measured GFR", Nat Rev Nephrol, 15, pp.784~ (2019)
- Nichols GA, "Health care costs by type of expenditure across eGFR stages among patients with and without diabetes, cardiovascular disease, and heart failure", J Am Soc Nephrol, 31, pp.1594~1601 (2020)
- GBD Chronic Kidney Disease Collaboration, "Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017", Lancet, 395, pp.709~733 (2020)
- Miller WG, "Estimated glomerular filtration rate; laboratory implementation and current global status", Adv Chronic Kidney Dis, 25, pp.7~13 (2018)
- Miller WG, "National Kidney Foundation Laboratory Engagement Working Group recommendations for implementing the CKD-EPI 2021 race-free equations for estimated glomerular filtration rate : practical guidance for clinical laboratories", Clin Chem, 68, pp.511~520 (2022)
- 김수경, "Current Status of Estimated Glomerular Filtration Rate Reporting in Korea", Laboratory Medicine and Quality Assurance, 41(4), pp.201~206 (2019), 대한진단검사정도관리협회[DOI]
- Costa NR, "Laboratory diagnosis of chronic kidney disease in adults : an overview of hospitals inserted in the Portuguese National Health System", J Bras Patol Med Lab, 53, pp.388~396 (2017)
- Madero M, "Creatinine-based formulae for estimating glomerular filtration rate : is it time to change to chronic kidney disease epidemiology collaboration equation?", Curr Opin Nephrol Hypertens, 20, pp.622~630 (2011)
- Levey AS, "A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group", Ann Intern Med, 130, pp.461~470 (1999)
- Levey AS, "A new equation to estimate glomerular filtration rate", Ann Intern Med, 150, pp.604~612 (2009)
- Delgado C, "Reassessing the inclusion of race in diagnosing kidney diseases : an interim report from the NKF-ASN task force", J Am Soc Nephrol, 32, pp.1305~1317 (2021)
- Cerdeña JP, "From race-based to race-conscious medicine : how anti-racist uprisings call us to act", Lancet, 396, pp.1125~1128 (2020)
- Vyas DA, "Hidden in plain sight–reconsidering the use of race correction in clinical algorithms", N Engl J Med, 383, pp.874~882 (2020)
- Oni-Orisan A, "Embracing genetic diversity to improve black health", N Engl J Med, 384, pp.1163~1167 (2021)
- Ioannidis JPA, "Recalibrating the use of race in medical research", JAMA, 325, pp.623~624 (2021)
- Pottel H, "Development and validation of a modified full age spectrum creatinine-based equation to estimate glomerular filtration rate : a cross-sectional analysis of pooled data", Ann Intern Med, 174, pp.183~191 (2021)
- Pottel H, "An estimated glomerular filtration rate equation for the full age spectrum", Nephrol Dial Transplant, 31, pp.798~806 (2016)
- "KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease", Kidney Int, 3, pp.19~62 (2013)
- Meeusen JW, "Clinical impact of the refit CKD-EPI 2021 creatinine-based eGFR equation", Clin Chem, 68, pp.534~539 (2022)
- Levey AS, "Improving glomerular filtration rate estimation-across the age and diversity spectrum", Ann Intern Med, 174, pp.265~267 (2021)
- Fleming JS, "Guidelines for the measurement of glomerular filtration rate using plasma sampling", Nucl Med Commun, 25, pp.759~769 (2004)
- Campbell MJ, "Calculating confidence intervals for some non-parametric analyses", Br Med J(Clin Res Ed), 296, pp.1454~1456 (1988)
- National Kidney Foundation, "K", DOQI clinical practice guidelines for chronic kidney disease : evaluation, classification, and stratification, 2002, pp.39(2 Suppl 1), S1~266
- Marzinke MA, "Limited evidence for use of a black race modifier in eGFR calculations : a systematic review", Clin Chem, 68, pp.521~533 (2022)
- Delgado C, "A unifying approach for GFR estimation : recommendations of the NKF-ASN task force on reassessing the inclusion of race in diagnosing kidney disease", Am J Kidney Dis, 79, pp.268~288 (2022)
- Jeong Tae-Dong, "Recent Trends in Creatinine Assays in Korea: Long-Term Accuracy-Based Proficiency Testing Survey Data by the Korean Association of External Quality Assessment Service (2011–2019)", Annals of Laboratory Medicine, 41(4), pp.372~379 (2021), 대한진단검사의학회[DOI]
- Arora P, "The MDRD equation underestimates the prevalence of CKD among blacks and overestimates the prevalence of CKD among whites compared to the CKD-EPI equation : a retrospective cohort study", BMC Nephrol, 13, pp.4~ (2012)
- Delanaye P, "MDRD or CKD-EPI study equations for estimating prevalence of stage 3 CKD in epidemiological studies : which difference? Is this difference relevant?", BMC Nephrol, 11, pp.8~ (2010)