Performance of glomerular filtration rate estimating equations in a community-based sample of Blacks and Whites: the multiethnic study of atherosclerosis.

Abstract

Background:

The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations are recommended for glomerular filtration rate (GFR) estimation in the general population. They have not been evaluated in community-based populations, including Blacks at higher levels of GFR, but are commonly applied in such populations.

Methods:

In an ancillary study of Multi-Ethnic Study of Atherosclerosis conducted at one site, we evaluated the performance of the CKD-EPI equations for creatinine (eGFRcr), cystatin C (eGFRcys) or the combination (eGFRcr-cys) compared with GFR measured as plasma clearance of iohexol.

Results:

Among 294 participants, the mean age was 71 (SD 9) years, 47% were Black, 48% were women and the mean measured GFR (mGFR) was 72.6 (SD 18.8) mL/min/1.73 m2. The CKD-EPI equations overestimated mGFR with a larger median bias for eGFRcr and eGFRcr-cys than eGFRcys [-8.3 (95% confidence interval -9.7, -6.5), -7.8 (-9.2, -6.2) and -3.7 (-5.0, -1.8) mL/min/1.73 m2, respectively], with smaller bias for those with lower compared with higher eGFR and by race compared with sex.

Conclusion:

The small differential bias of the CKD-EPI equation between races suggests that they can be used in Blacks as well as Whites in older community-based adults. The large differential bias in women versus men in all equations is in contrast to other studies and is unexplained. Further studies are required in multiracial and multiethnic community-based cohorts, taking into account differences in GFR measurement methods.

• Authors: Lesley A Inker, Andrew S Levey, Hocine Tighiouart, Tariq Shafi, John H Eckfeldt, Craig Johnson, Aghogho Okparavero, Wendy S Post, Josef Coresh, Michael G Shlipak
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 33 Issue 3 Pg. 417-425 (03 01 2018) ISSN: 1460-2385 [Electronic] England
• PMID: 28505377 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Chemical References

• Cystatin C
• Creatinine

Topics

• Adult
• Aged
• Algorithms
• Atherosclerosis (physiopathology)
• Black People (statistics & numerical data)
• Creatinine (blood)
• Cystatin C (blood)
• Ethnicity (statistics & numerical data)
• Female
• Glomerular Filtration Rate
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Renal Insufficiency, Chronic (blood, diagnosis, epidemiology)
• White People (statistics & numerical data)