TY - JOUR
T1 - Development and Validation of a Modified Full Age Spectrum Creatinine-Based Equation to Estimate Glomerular Filtration Rate
T2 - A Cross-sectional Analysis of Pooled Data
AU - Pottel, Hans
AU - Björk, Jonas
AU - Courbebaisse, Marie
AU - Couzi, Lionel
AU - Ebert, Natalie
AU - Eriksen, Björn O
AU - Dalton, R Neil
AU - Dubourg, Laurence
AU - Gaillard, François
AU - Garrouste, Cyril
AU - Grubb, Anders
AU - Jacquemont, Lola
AU - Hansson, Magnus
AU - Kamar, Nassim
AU - Lamb, Edmund J
AU - Legendre, Christophe
AU - Littmann, Karin
AU - Mariat, Christophe
AU - Melsom, Toralf
AU - Rostaing, Lionel
AU - Rule, Andrew D
AU - Schaeffner, Elke
AU - Sundin, Per-Ola
AU - Turner, Stephen
AU - Bökenkamp, Arend
AU - Berg, Ulla
AU - Åsling-Monemi, Kajsa
AU - Selistre, Luciano
AU - Åkesson, Anna
AU - Larsson, Anders
AU - Nyman, Ulf
AU - Delanaye, Pierre
N1 - Funding Information: Disclaimer: The CRIC Study was conducted by the CRIC investigators and supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The CRIC data reported here were supplied by the NIDDK Central Repository. This manuscript was not prepared in collaboration with the CRIC investigators and does not necessarily reflect the opinions or views of the CRIC investigators, NIDDK Central Repository, or NIDDK. Funding Information: Grant Support: By grant 2019-00198 from the Swedish Research Council (Vetenskapsrådet). Publisher Copyright: © 2021 American College of Physicians. All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Background: The Chronic Kidney Disease in Children Study (CKiD) equation for children and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for adults are recommended serum creatinine (SCr)-based calculations for estimating glomerular filtration rate (GFR). However, these equations, as well as their combination, have limitations, notably the problem of implausible changes in GFR during the transition from adolescence to adulthood and overestimation of GFR in young adults. The full age spectrum (FAS) equation addresses these issues but overestimates GFR when SCr levels are low. Objective: To develop and validate a modified FAS SCr-based equation combining design features of the FAS and CKD-EPI equations. Design: Cross-sectional analysis with separate pooled data sets for development and validation. Setting: Research and clinical studies (n = 13) with measured GFR available. Patients: 11 251 participants in 7 studies (development and internal validation data sets) and 8378 participants in 6 studies (external validation data set). Measurements: Clearance of an exogenous marker (reference method), SCr level, age, sex, and height were used to develop a new equation to estimate GFR. Results: The new European Kidney Function Consortium (EKFC) equation is a FAS equation with low bias (-1.2 mL/min/1.73 m2 [95% CI, -2.7 to 0.0 mL/min/1.73 m2] in children and -0.9 mL/ min/1.73 m2 [CI, -1.2 to -0.5 mL/min/1.73 m2] in adults) across the FAS (2 to 90 years) and SCr range (40 to 490 μmol/L [0.45 to 5.54 mg/dL]) and with fewer estimation errors exceeding 30% (6.5% [CI, 3.8% to 9.1%] in children and 3.1% [CI, 2.5% to 3.6%] in adults) compared with the CKiD and CKD-EPI equations. Limitation: No Black patients were included. Conclusion: The new EKFC equation shows improved accuracy and precision compared with commonly used equations for estimating GFR from SCr levels.
AB - Background: The Chronic Kidney Disease in Children Study (CKiD) equation for children and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for adults are recommended serum creatinine (SCr)-based calculations for estimating glomerular filtration rate (GFR). However, these equations, as well as their combination, have limitations, notably the problem of implausible changes in GFR during the transition from adolescence to adulthood and overestimation of GFR in young adults. The full age spectrum (FAS) equation addresses these issues but overestimates GFR when SCr levels are low. Objective: To develop and validate a modified FAS SCr-based equation combining design features of the FAS and CKD-EPI equations. Design: Cross-sectional analysis with separate pooled data sets for development and validation. Setting: Research and clinical studies (n = 13) with measured GFR available. Patients: 11 251 participants in 7 studies (development and internal validation data sets) and 8378 participants in 6 studies (external validation data set). Measurements: Clearance of an exogenous marker (reference method), SCr level, age, sex, and height were used to develop a new equation to estimate GFR. Results: The new European Kidney Function Consortium (EKFC) equation is a FAS equation with low bias (-1.2 mL/min/1.73 m2 [95% CI, -2.7 to 0.0 mL/min/1.73 m2] in children and -0.9 mL/ min/1.73 m2 [CI, -1.2 to -0.5 mL/min/1.73 m2] in adults) across the FAS (2 to 90 years) and SCr range (40 to 490 μmol/L [0.45 to 5.54 mg/dL]) and with fewer estimation errors exceeding 30% (6.5% [CI, 3.8% to 9.1%] in children and 3.1% [CI, 2.5% to 3.6%] in adults) compared with the CKiD and CKD-EPI equations. Limitation: No Black patients were included. Conclusion: The new EKFC equation shows improved accuracy and precision compared with commonly used equations for estimating GFR from SCr levels.
UR - http://www.scopus.com/inward/record.url?scp=85102153377&partnerID=8YFLogxK
U2 - https://doi.org/10.7326/M20-4366
DO - https://doi.org/10.7326/M20-4366
M3 - Article
C2 - 33166224
SN - 0003-4819
VL - 174
SP - 183
EP - 191
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
IS - 2
ER -