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6. Assessment of Glomerular Filtration Rate in Patients with Cancer: A Statement from the American Society of Onco-Nephrology

Author

Kitchlu, Abhijat, Costa E Silva, Verônica T., Anand, Shuchi, Kala, Jaya, Abudayyeh, Ala, Inker, Lesley A., Rosner, Mitchell H., Karam, Sabine, Gudsoorkar, Prakash, Gupta, Shruti, Chen, Sheldon, Klomjit, Nattawat, Leung, Nelson, Milanez, Tomaz, Motwani, Shveta S., Khalid, Sheikh B., Srinivasan, Vinay, Wanchoo, Rimda, Beumer, Jan H., Liu, Geoffrey, Tannir, Nizar M., Orchanian-Cheff, Ani, Geng, Yimin, and Herrmann, Sandra M.

Published
2024
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7. Assessment of GFR in Patients with Cancer Part 2: Anticancer Therapies – Perspectives from the ASON

Author

Kitchlu, Abhijat, Costa E Silva, Verônica T., Anand, Shuchi, Kala, Jaya, Abudayyeh, Ala, Inker, Lesley A., Rosner, Mitchell H., Karam, Sabine, Gudsoorkar, Prakash, Gupta, Shruti, Chen, Sheldon, Klomjit, Nattawat, Leung, Nelson, Milanez, Tomaz, Motwani, Shveta S., Khalid, Sheikh B., Srinivasan, Vinay, Wanchoo, Rimda, Beumer, Jan H., Liu, Geoffrey, Tannir, Nizar M., Orchanian-Cheff, Ani, Geng, Yimin, and Herrmann, Sandra M.

Published
2024
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9. A meta-analysis of randomized controlled clinical trials for implications of acute treatment effects on glomerular filtration rate for long-term kidney protection

Author

Heerspink, Hiddo J.L., Eddington, Devin, Chaudhari, Juhi, Estacio, Raymond, Imai, Enyu, Goicoechea, Marian, Hannedouche, Thierry, Haynes, Richard, Jafar, Tazeen H., Johnson, David W., van Kruijsdijk, Rob C.M., Lewis, Julia B., Li, Philip K.T., Neuen, Brendon L., Perrone, Ronald D., Ruggenenti, Piero, Wanner, Christoph, Woodward, Mark, Xie, Di, Greene, Tom, and Inker, Lesley A.

Published
2024
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10. Glomerular Filtration Rate Estimation Using β2-Microglobulin and β-Trace Protein in Adults With Solid Tumors: A Prospective Cross-Sectional Study

Author

Costa e Silva, Verônica T., Gil, Luiz A., Jr, Inker, Lesley A., Caires, Renato A., Costalonga, Elerson, Coura-Filho, George, Sapienza, Marcelo T., Castro, Gilberto, Jr, Estevez-Diz, Maria D.P., Zanetta, Dirce Maria T., Antonângelo, Leila, Marçal, Lia, Tighiouart, Hocine, Miao, Shiyuan, Mathew, Paul, Levey, Andrew S., and Burdmann, Emmanuel A.

Published
2024
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11. Longitudinal Plasma Metabolome Patterns and Relation to Kidney Function and Proteinuria in Pediatric CKD

Author

Lee, Arthur M., Xu, Yunwen, Hu, Jian, Xiao, Rui, Hooper, Stephen R., Hartung, Erum A., Coresh, Josef, Rhee, Eugene P., Vasan, Ramachandran S., Kimmel, Paul L., Warady, Bradley A., Furth, Susan L., Denburg, Michelle R., Abraham, Alison, Anderson, Amanda, Ballard, Shawn, Bonventre, Joseph, Clish, Clary, Collins, Heather, Coca, Steven, Coresh, Josef, Deo, Rajat, Denburg, Michelle, Dubin, Ruth, Feldman, Harold I., Ferket, Bart S., Foster, Meredith, Furth, Susan, Ganz, Peter, Gossett, Daniel, Grams, Morgan, Greenberg, Jason, Gutiérrez, Orlando M., Hostetter, Tom, Inker, Lesley A., Ix, Joachim, Kimmel, Paul L., Klein, Jon, Levey, Andrew S., Massaro, Joseph, McMahon, Gearoid, Mifflin, Theodore, Nadkarni, Girish N., Parikh, Chirag, Ramachandran, Vasan S., Rebholz, Casey, Rhee, Eugene, Rovin, Brad, Sarnak, Mark, Sabbisetti, Venkata, Schelling, Jeffrey, Seegmiller, Jesse, Shlipak, Michael G., Shou, Haochang, Tin, Adriene, Waikar, Sushrut, Warady, Bradley, Whitehead, Krista, and Xie, Dawei

Published
2024
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12. Executive summary of the KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease: known knowns and known unknowns

Author

Levin, Adeera, Ahmed, Sofia B., Carrero, Juan Jesus, Foster, Bethany, Francis, Anna, Hall, Rasheeda K., Herrington, Will G., Hill, Guy, Inker, Lesley A., Kazancıoğlu, Rümeyza, Lamb, Edmund, Lin, Peter, Madero, Magdalena, McIntyre, Natasha, Morrow, Kelly, Roberts, Glenda, Sabanayagam, Dharshana, Schaeffner, Elke, Shlipak, Michael, Shroff, Rukshana, Tangri, Navdeep, Thanachayanont, Teerawat, Ulasi, Ifeoma, Wong, Germaine, Yang, Chih-Wei, Zhang, Luxia, Robinson, Karen A., Wilson, Lisa, Wilson, Renee F., Kasiske, Bertram L., Cheung, Michael, Earley, Amy, and Stevens, Paul E.

Published
2024
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13. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease

Author

Stevens, Paul E., Ahmed, Sofia B., Carrero, Juan Jesus, Foster, Bethany, Francis, Anna, Hall, Rasheeda K., Herrington, Will G., Hill, Guy, Inker, Lesley A., Kazancıoğlu, Rümeyza, Lamb, Edmund, Lin, Peter, Madero, Magdalena, McIntyre, Natasha, Morrow, Kelly, Roberts, Glenda, Sabanayagam, Dharshana, Schaeffner, Elke, Shlipak, Michael, Shroff, Rukshana, Tangri, Navdeep, Thanachayanont, Teerawat, Ulasi, Ifeoma, Wong, Germaine, Yang, Chih-Wei, Zhang, Luxia, and Levin, Adeera

Published
2024
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15. A meta-analysis of GFR slope as a surrogate endpoint for kidney failure

Author

Inker, Lesley A., Collier, Willem, Greene, Tom, Miao, Shiyuan, Chaudhari, Juhi, Appel, Gerald B., Badve, Sunil V., Caravaca-Fontán, Fernando, Del Vecchio, Lucia, Floege, Jürgen, Goicoechea, Marian, Haaland, Benjamin, Herrington, William G., Imai, Enyu, Jafar, Tazeen H., Lewis, Julia B., Li, Philip K. T., Maes, Bart D., Neuen, Brendon L., Perrone, Ronald D., Remuzzi, Giuseppe, Schena, Francesco P., Wanner, Christoph, Wetzels, Jack F. M., Woodward, Mark, and Heerspink, Hiddo J. L.

Published
2023
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16. New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race

Author

Inker, Lesley A, Eneanya, Nwamaka D, Coresh, Josef, Tighiouart, Hocine, Wang, Dan, Sang, Yingying, Crews, Deidra C, Doria, Alessandro, Estrella, Michelle M, Froissart, Marc, Grams, Morgan E, Greene, Tom, Grubb, Anders, Gudnason, Vilmundur, Gutiérrez, Orlando M, Kalil, Roberto, Karger, Amy B, Mauer, Michael, Navis, Gerjan, Nelson, Robert G, Poggio, Emilio D, Rodby, Roger, Rossing, Peter, Rule, Andrew D, Selvin, Elizabeth, Seegmiller, Jesse C, Shlipak, Michael G, Torres, Vicente E, Yang, Wei, Ballew, Shoshana H, Couture, Sara J, Powe, Neil R, and Levey, Andrew S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Kidney Disease, Renal and urogenital, Adult, Aged, Algorithms, Black People, Creatinine, Cystatin C, Datasets as Topic, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Racial Groups, Renal Insufficiency, Chronic, United States, Black or African American, Chronic Kidney Disease Epidemiology Collaboration, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundCurrent 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.MethodsWe 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.ResultsIn 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.ConclusionsNew 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. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases.).

Published
2021

18. Reassessing the Inclusion of Race in Diagnosing Kidney Diseases: An Interim Report From the NKF-ASN Task Force

Author

Delgado, Cynthia, Baweja, Mukta, Burrows, Nilka Ríos, Crews, Deidra C, Eneanya, Nwamaka D, Gadegbeku, Crystal A, Inker, Lesley A, Mendu, Mallika L, Miller, W Greg, Moxey-Mims, Marva M, Roberts, Glenda V, St Peter, Wendy L, Warfield, Curtis, and Powe, Neil R

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Kidney Disease, 8.1 Organisation and delivery of services, Health and social care services research, Renal and urogenital, Black or African American, Glomerular Filtration Rate, Health Status Disparities, Healthcare Disparities, Humans, Racial Groups, Renal Insufficiency, Chronic, United States, creatinine, estimated glomerular filtration rate, estimating equation, ethnicity, filtration marker, health care equity, health disparities, kidney disease, kidney disease diagnosis, laboratory medicine, medical decision making, patient-centered care, public health, race, race coefficient, racism, renal function, social determinants of health, Public Health and Health Services, Urology & Nephrology, Clinical sciences
Abstract

For almost 2 decades, equations that use serum creatinine, age, sex, and race to estimate glomerular filtration rate (GFR) have included "race" as Black or non-Black. Given considerable evidence of disparities in health and health care delivery in African American communities, some regard keeping a race term in GFR equations as a practice that differentially influences access to care and kidney transplantation. Others assert that race captures important non-GFR determinants of serum creatinine and its removal from the calculation may perpetuate other disparities. The National Kidney Foundation (NKF) and American Society of Nephrology (ASN) established a task force in 2020 to reassess the inclusion of race in the estimation of GFR in the United States and its implications for diagnosis and subsequent management of patients with, or at risk for, kidney diseases. This interim report details the process, initial assessment of evidence, and values defined regarding the use of race to estimate GFR. We organized activities in phases: (1) clarify the problem and examine evidence, (2) evaluate different approaches to address use of race in GFR estimation, and (3) make recommendations. In phase 1, we constructed statements about the evidence and defined values regarding equity and disparities; race and racism; GFR measurement, estimation, and equation performance; laboratory standardization; and patient perspectives. We also identified several approaches to estimate GFR and a set of attributes to evaluate these approaches. Building on evidence and values, the attributes of alternative approaches to estimate GFR will be evaluated in the next phases and recommendations will be made.

Published
2021

19. Combination Treatment with Verinurad and Allopurinol in CKD: A Randomized Placebo and Active Controlled Trial

Author

Heerspink, Hiddo J.L., Stack, Austin G., Terkeltaub, Robert, Jongs, Niels, Inker, Lesley A., Bjursell, Magnus, Maklad, Noha, Perl, Shira, Eklund, Olof, Rikte, Tord, Sjöström, C. David, Perkovic, Vlado, Chmelickova, Hana, Lukac, Martin, Bucek, Petr, Drasnar, Tomas, Dussol, Bertrand, Guerrot, Dominique, Legrand, Eric, Boffa, Jean-Jacques, Halimi, Jean-Michel, Zaoui, Philippe, Letoha, Annamaria, Hajdu, Csaba, Pall, Denes, Peterfai, Eva, Csécsei, Gyöngyi, Bezzegh, Katalin, Deak, Laszlo, Konyves, Laszlo, Zsom, Marianna, Danos, Peter, Vangel, Sandor, Vasas, Szilard, Oroszlan, Tamas, Zilahi, Zsolt, Leiba, Adi, Grossman, Alon, Leibowitz, Avshalom, Itzhak, Baruch, Daoud, Deeb, Farber, Evgeny, Adawi, Faiad, Nakhoul, Farid M., Chernin, Gil, Kenis, Irina, Wainstein, Julio, Zeller, Lior, Elias, Mazen, Atar, Shaul, Frajewicki, Victor, Yagil, Yoram, Armaly, Zaher A., Esposito, Ciro, Viazzi, Francesca, Gambaro, Giovanni, Piatti, Piermarco, Bonadonna, Riccardo C., Arias Delgadillo, Cristhian Ronaldt, Flores, Fernando Jimenez, Aguilera Real, Manuel Enrique, Fajardo-Campos, Pedro, Violante Ortiz, Rafael Margarito, Luna Ceballos, Rosa Isela, Duran-Barragan, Sergio, Zytkiewicz-Jaruga, Danuta, Krzyzagorska, Ewa, Skokowska, Ewa, Klodawska, Katarzyna, Mordaka, Robert, Mazur, Stanislaw, Stasinska, Teresa, Sulowicz, Wladyslaw, Constantin, Ciprian, Negru, Doru, Paveliu, Fraga-Silvia, Negrisanu, Gabriela Doina, Szilagyi, Iosif, Busegeanu, Mihaela Magdalena G., Pena, Mihai Cosmin, Avram, Rodica Ioana, Ardelean, Silvia Luminita, Ilavska, Adriana, Dzupina, Andrej, Oroszova, Aniko, Kolesarova, Eva, Obetkova, Ida, Smatanova, Iveta, Babikova, Jana, Fulop, Peter, Haffner, Radovan, Rayner, Brian L., Kruger, Dawid Stephanus, Urbach, Dorothea Vera, Mitha, Essack, Vally Mahomed Latiff, Gulam Hoosain, Makan, Hemant, du Plessis, Hermanus, Jurgens, Jaco Cornelius, Reddy, Jeevren, Trokis, Julien S., McHarry, Kirsten, Distiller, Lawrence Allen, Mayet, Leila, Burgess, Lesley Jean, Van Zyl, Louis Johan, Joshi, Mukesh P., Sebastian, Peter John, Du Toit, Samantha Maria, Blignaut, Suzanne C., Serrano, Antonio Galan, Morales, Cristobal, Poch, Esteban, Mosquera, Eva Marquez, Castro, Fernando Cereto, Gonzalez Martinez, Francisco Javier, Perez- Contreras, Francisco Javier, Fernandez-Fresnedo, Gema, Garcia Mendez, Isabel Fuencisla, Perez, Jonay Pantoja, Martinez, Jordi Calabia, Gorriz Teruel, Jose Luis, Nieto Iglesias, Luis Javier, Munoz-Torres, Manuel, Munar Vila, Maria Antonia, Arenas Jimenez, Maria Dolores, Dominguez-Lopez, Marta E., Val, Miguel Hueso, Terrades, Natalia Ramos, Olmo, Rafael Santamaria, Malek Marin, Tamara Gelen, Arif, Ahmed A., Lee, Benjamin J., Mehta, Bhasker R., Baker, Bruce H., Jere, Charles S., Bains, David G., Stricklin, David G., Cheung, Deanna, Echeverri, Diego, Vera, Edgard, Heurich, Eva-Maria, Sterba, Gary A., Hernandez, German T., Paez, Henry E., Acosta, Idalia A., Ahmed, Intekhab, Sachmechi, Issac, Madu, Ivy-Joan E., Obhrai, Jagdeep Singh, Hammoud, Jamal A., Tumlin, James A., Cain, James, Moya-Hechevarria, Jaynier, Connaire, Jeffrey J., Haggiagi, Jehad, Odren, Jennifer A., Bellucci-Jackson, Jennifer M., Yan, Jieshi, Parker, John C., Tolins, Jonathan P., Gomez-Cortes, Jose D., Cardona, Jose F., Mandry, Jose M., Olivero, Juan Jorge, Hendon, Kendra S., Kaveh, Kianoosh, Kooienga, Laura A., Bermudez, Lidia R., Rich, Lisa M., Gold, Marina, Gonzalez, Marisela, Schaefer, Matthew E., Welch, Michelle, Moustafa, Moustafa A., Mussaji, Murtaza, Pergola, Pablo E., Phaosawasdi, Piangwarin, Silva, Ricardo A., Presas, Ricardo, Lynn, Robert I., Kronfli, Saeed J., Ventrapragada, Sailaja V., Niranjan, Sankar N., Husain, Sayed, Satko, Scott, Jabbour, Serge A., Rovner, Sergio F., Gouge, Steven F., Joshi, Sudhir S., Ramachandran Subramanian, Varagur Bala, Lane, Wendy, Calhoun, Wesley, and Durham, William

Published
2024
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22. A New Panel-Estimated GFR, Including β2-Microglobulin and β-Trace Protein and Not Including Race, Developed in a Diverse Population

Author

Inker, Lesley A, Couture, Sara J, Tighiouart, Hocine, Abraham, Alison G, Beck, Gerald J, Feldman, Harold I, Greene, Tom, Gudnason, Vilmundur, Karger, Amy B, Eckfeldt, John H, Kasiske, Bertram L, Mauer, Michael, Navis, Gerjan, Poggio, Emilio D, Rossing, Peter, Shlipak, Michael G, Levey, Andrew S, Collaborators, CKD-EPI GFR, Andresdottir, Margret B, Gudmundsdottir, Hrefna, Indridason, Olafur S, Palsson, Runolfur, Kimmel, Paul, Weir, Matt, Kalil, Roberto, Pesavento, Todd, Porter, Anna, Taliercio, Jonathan, Hsu, Chi-yuan, Chen, Jing, Sinkeler, Steef, Wyatt, Christina, Krishnasami, Zipporah, Hellinger, James, Margolick, Joseph, Kingsley, Lawrence, Witt, Mallory, Wolinsky, Steven, Shafi, Tariq, Post, Wendy, Doria, Alessandro, and Parving, Hans-Henrik

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Disparities, Clinical Research, Kidney Disease, Minority Health, 4.2 Evaluation of markers and technologies, Renal and urogenital, Adolescent, Adult, Black or African American, Aged, Aged, 80 and over, Black People, Case-Control Studies, Chromium Radioisotopes, Creatinine, Cystatin C, Edetic Acid, Female, Glomerular Filtration Rate, Humans, Intramolecular Oxidoreductases, Iohexol, Iothalamic Acid, Lipocalins, Male, Middle Aged, Renal Insufficiency, Chronic, Reproducibility of Results, Severity of Illness Index, White People, Young Adult, beta 2-Microglobulin, CKD-EPI GFR Collaborators, African American, Black race, GFR estimation, Glomerular filtration rate, bias, creatinine, cystatin C, estimating equations, filtration marker, kidney disease diagnosis, laboratory testing, race, race-based medicine, renal function, β(2)-microglobulin, β-trace protein, Public Health and Health Services, Urology & Nephrology, Clinical sciences
Abstract

Rationale and objectiveGlomerular filtration rate (GFR) estimation based on creatinine and cystatin C (eGFRcr-cys) is more accurate than estimated GFR (eGFR) based on creatinine or cystatin C alone (eGFRcr or eGFRcys, respectively), but the inclusion of creatinine in eGFRcr-cys requires specification of a person's race. β2-Microglobulin (B2M) and β-trace protein (BTP) are alternative filtration markers that appear to be less influenced by race than creatinine is.Study designStudy of diagnostic test accuracy.Setting and participantsDevelopment in a pooled population of 7 studies with 5,017 participants with and without chronic kidney disease. External validation in a pooled population of 7 other studies with 2,245 participants.Tests comparedPanel eGFR using B2M and BTP in addition to cystatin C (3-marker panel) or creatinine and cystatin C (4-marker panel) with and without age and sex or race.OutcomesGFR measured as the urinary clearance of iothalamate, plasma clearance of iohexol, or plasma clearance of [51Cr]EDTA.ResultsMean measured GFRs were 58.1 and 83.2 mL/min/1.73 m2, and the proportions of Black participants were 38.6% and 24.0%, in the development and validation populations, respectively. In development, addition of age and sex improved the performance of all equations compared with equations without age and sex, but addition of race did not further improve the performance. In validation, the 4-marker panels were more accurate than the 3-marker panels (P < 0.001). The 3-marker panel without race was more accurate than eGFRcys (percentage of estimates greater than 30% different from measured GFR [1 - P30] of 15.6% vs 17.4%; P = 0.01), and the 4-marker panel without race was as accurate as eGFRcr-cys (1 - P30 of 8.6% vs 9.4%; P = 0.2). Results were generally consistent across subgroups.LimitationsNo representation of participants with severe comorbid illness and from geographic areas outside of North America and Europe.ConclusionsThe 4-marker panel eGFR is as accurate as eGFRcr-cys without requiring specification of race. A more accurate race-free eGFR could be an important advance.

Published
2021

29. Circulating Metabolomic Associations with Neurocognitive Outcomes in Pediatric CKD

Author

Lee, Arthur M., Xu, Yunwen, Hooper, Stephen R., Abraham, Alison G., Hu, Jian, Xiao, Rui, Matheson, Matthew B., Brunson, Celina, Rhee, Eugene P., Coresh, Josef, Vasan, Ramachandran S., Schrauben, Sarah, Kimmel, Paul L., Warady, Bradley A., Furth, Susan L., Hartung, Erum A., Denburg, Michelle R., Abraham, Alison, Anderson, Amanda, Ballard, Shawn, Bonventre, Joseph, Clish, Clary, Collins, Heather, Coca, Steven, Coresh, Josef, Deo, Rajat, Denburg, Michelle, Dubin, Ruth, Feldman, Harold I., Ferket, Bart S., Foster, Meredith, Furth, Susan, Ganz, Peter, Gossett, Daniel, Grams, Morgan, Greenberg, Jason, Gutiérrez, Orlando M., Hostetter, Tom, Inker, Lesley A., Ix, Joachim, Kimmel, Paul L., Klein, Jon, Levey, Andrew S., Massaro, Joseph, McMahon, Gearoid, Mifflin, Theodore, Nadkarni, Girish N., Parikh, Chirag, Ramachandran, Vasan S., Rebholz, Casey, Rhee, Eugene, Rovin, Brad, Sarnak, M., Sabbisetti, Venkata, Schelling, Jeffrey, Seegmiller, Jesse, Shlipak, Michael G., Shou, Haochang, Tin, Adriene, Waikar, Sushrut, Warady, Bradley, Whitehead, Krista, and Xie, Dawei

Published
2024
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32. Improved Performance in Measurement of Serum Cystatin C by Laboratories Participating in the College of American Pathologists 2019 CYS Survey

Author

Karger, Amy B., Long, Thomas, Inker, Lesley A., and Eckfeldt, John H.

Subjects
Chronic kidney failure -- Diagnosis, Health
Abstract

* Context.--Use of cystatin C for glomerular filtration rate estimation (eGFR) has garnered heightened interest as a means to avoid race-based medicine, since [eGFR.sub.cys] equations do not require specification of race. Before considering more widespread use of cystatin C, it is important to confirm that assays provide accurate measurements of cystatin C concentration, to ensure accurate GFR estimates. Objective.--To determine if the accuracy of cystatin C measurements in laboratories participating in the College of American Pathologists (CAP) Cystatin C (CYS) survey has improved since 2014. Design.--Two fresh frozen serum pools, the first from healthy donors without chronic kidney disease (CKD), and the second from patients with CKD, along with a synthetically prepared elevated cystatin C pool, were sent to laboratories participating in the 2019 CYS-A survey. Target values were established by using 2 immunoassays and a bracketed 2-point calibration with diluted ERM-DA471/IFCC reference material. Results.--For the healthy donor fresh frozen pool (ERM-DA471/IFCC-traceable target of 0.725 mg/L), the all-method mean (standard deviation, coefficient of variation) was 0.731 mg/L (0.071, 9.7%). For the CKD pool (ERMD-A471/IFCC-traceable target of 2.136 mg/L), the all-method mean was 2.155 mg/L (0.182, 8.4%). For the synthetically spiked pool (ERM-DA471/IFCC-traceable target of 1.843 mg/L), the all-method mean was 1.886 mg/L (0.152, 8.1%). This represents marked improvement in accuracy and between-method agreement compared to the 2014 CAP survey. Conclusions.--Manufacturers have markedly improved accuracy and between-method agreement of cystatin C measurement procedures since 2014, which allows for greater confidence in estimated GFR relying on cystatin C. doi: 10.5858/arpa.2021-0306-CP, Cystatin C, a low-molecular-weight protein freely filtered by the kidneys, is an established alternative to creatinine for glomerular filtration rate (GFR) estimation. (1-10) Current Kidney Disease: Improving Global Outcomes (KDIGO) [...]

Published
2022
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34. A National Registry for People With All Stages of Kidney Disease: The National Kidney Foundation (NKF) Patient Network

Author

Inker, Lesley A., Ferrè, Silvia, Baliker, Mary, Barr, Anne, Bonebrake, Lisa, Chang, Alexander R., Chaudhari, Juhi, Cooper, Kerry, Diamantidis, Clarissa J., Forfang, Derek, Gillespie, Barbara, Gregoriou, Petros, Gwadry-Sridhar, Femida, Ladin, Keren, Maxwell, Cari, Mitchell, Kristi R., Murphy, Kathleen P., Rakibuz-Zaman, Muhammad, Rocco, Michael V., Spry, Leslie A., Sharma, Amit, Tangri, Navdeep, Warfield, Curtis, and Willis, Kerry

Published
2023
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35. Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure

Author

Griffin, Matthew, Rao, Veena S, Fleming, James, Raghavendra, Parinita, Turner, Jeffrey, Mahoney, Devin, Wettersten, Nicholas, Maisel, Alan, Ivey-Miranda, Juan B, Inker, Lesley, Tang, Wai Hong Wilson, Wilson, Francis Perry, and Testani, Jeffrey M

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Cardiovascular, Clinical Research, Acute Disease, Aged, Biomarkers, Creatinine, Diuretics, Female, Heart Failure, Hospital Mortality, Humans, Male, Prognosis, Retrospective Studies, Survival Rate, United States, Water-Electrolyte Imbalance, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

Hemoconcentration during the treatment of acute decompensated heart failure is a surrogate for plasma volume reduction and is associated with improved survival, but most definitions only allow for hemoconcentration to be determined retrospectively. An increase in serum creatinine can also be a marker of aggressive decongestion, but in isolation is not specific. Our objective was to determine if combined hemoconcentration and worsening creatinine could better identify patients that were aggressively treated and, as such, may have improved postdischarge outcomes. A total of 4,181 patients hospitalized with acute decompensated heart failure were evaluated. Those who experienced both hemoconcentration and worsening creatinine at any point had a profile consistent with aggressive in-hospital treatment and longer length of stay (p

Published
2019

36. Metabolomic profiling to improve glomerular filtration rate estimation: a proof-of-concept study

Author

Coresh, Josef, Inker, Lesley A, Sang, Yingying, Chen, Jingsha, Shafi, Tariq, Post, Wendy S, Shlipak, Michael G, Ford, Lisa, Goodman, Kelli, Perichon, Regis, Greene, Tom, and Levey, Andrew S

Subjects
Medical Biochemistry and Metabolomics, Biomedical and Clinical Sciences, Cardiovascular, Kidney Disease, Atherosclerosis, Renal and urogenital, Adult, Aged, Aged, 80 and over, Biomarkers, Chromatography, Liquid, Creatinine, Cross-Sectional Studies, Cystatin C, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Male, Metabolomics, Middle Aged, Proof of Concept Study, Renal Insufficiency, Chronic, Time Factors, creatinine, estimating equations, GFR, kidney function, metabolomics, Clinical Sciences, Urology & Nephrology, Clinical sciences
Abstract

BackgroundEstimation of glomerular filtration rate (GFR) using estimated glomerular filtration rate creatinine (eGFRcr) is central to clinical practice but has limitations. We tested the hypothesis that serum metabolomic profiling can identify novel markers that in combination can provide more accurate GFR estimates.MethodsWe performed a cross-sectional study of 200 African American Study of Kidney Disease and Hypertension (AASK) and 265 Multi-Ethnic Study of Atherosclerosis (MESA) participants with measured GFR (mGFR). Untargeted gas chromatography/dual mass spectrometry- and liquid chromatography/dual mass spectrometry-based quantification was followed by the development of targeted assays for 15 metabolites. On the log scale, GFR was estimated from single- and multiple-metabolite panels and compared with eGFR using the Chronic Kidney Disease Epidemiology equations with creatinine and/or cystatin C using established metrics, including the proportion of errors >30% of mGFR (1-P30), before and after bias correction.ResultsOf untargeted metabolites in the AASK and MESA, 283 of 780 (36%) and 387 of 1447 (27%), respectively, were significantly correlated (P ≤ 0.001) with mGFR. A targeted metabolite panel eGFR developed in the AASK and validated in the MESA was more accurate (1-P30 3.7 and 1.9%, respectively) than eGFRcr [11.2 and 18.5%, respectively (P  0.05) and 9.1% (P

Published
2019

39. Association of Uremic Solutes With Cardiovascular Death in Diabetic Kidney Disease

Author

Massaro, Joseph, Clish, Clary, Denburg, Michelle, Furth, Susan, Warady, Bradley, Bonventre, Joseph, Waikar, Sushrut, McMahon, Gearoid, Sabbisetti, Venkata, Coresh, Josef, Grams, Morgan, Rebholz, Casey, Abraham, Alison, Tin, Adriene, Parikh, Chirag, Klein, Jon, Coca, Steven, Ferket, Bart S., Nadkarni, Girish N., Gossett, Daniel, Rovin, Brad, Levey, Andrew S., Inker, Lesley A., Foster, Meredith, Dubin, Ruth, Deo, Rajat, Anderson, Amanda, Mifflin, Theodore, Xie, Dawei, Shou, Haochang, Ballard, Shawn, Whitehead, Krista, Collins, Heather, Greenberg, Jason, Ganz, Peter, Sapa, Hima, Gutiérrez, Orlando M., Shlipak, Michael G., Katz, Ronit, Ix, Joachim H., Sarnak, Mark J., Cushman, Mary, Rhee, Eugene P., Kimmel, Paul L., Vasan, Ramachandran S., Schrauben, Sarah J., Feldman, Harold I., Seegmiller, Jesse C., Brunengraber, Henri, Hostetter, Thomas H., and Schelling, Jeffrey R.

Published
2022
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40. Clinical Trial Considerations in Developing Treatments for Early Stages of Common, Chronic Kidney Diseases: A Scientific Workshop Cosponsored by the National Kidney Foundation and the US Food and Drug Administration

Author

Little, Dustin, Jha, Vivek, West, Melissa, Levey, Andrew S., Walsh, Michael, Mottl, Amy K., Tangri, Navdeep, Madero, Magdalena, Patel, Uptal D., Gillespie, Barbara S., Crews, Deidra C., Levin, Adeera, Inker, Lesley A., Grams, Morgan E., Guðmundsdóttir, Hrefna, McEwan, Phil, Friedman, Robert, Thompson, Aliza, Weiner, Daniel E., Willis, Kerry, and Heerspink, Hiddo J.L.

Published
2022
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43. Panel estimated Glomerular Filtration Rate (GFR): Statistical considerations for maximizing accuracy in diverse clinical populations.

Author

Fino, Nora F., Inker, Lesley A., Greene, Tom, Adingwupu, Ogechi M., Coresh, Josef, Seegmiller, Jesse, Shlipak, Michael G., Jafar, Tazeen H., Kalil, Roberto, Costa e Silva, Veronica T., Gudnason, Vilmundur, Levey, Andrew S., and Haaland, Ben

Subjects
*GLOMERULAR filtration rate, *CYSTATIN C, *DISEASE management, *EPIDERMAL growth factor receptors, *KIDNEY diseases
Abstract

Assessing glomerular filtration rate (GFR) is critical for diagnosis, staging, and management of kidney disease. However, accuracy of estimated GFR (eGFR) is limited by large errors (>30% error present in >10–50% of patients), adversely impacting patient care. Errors often result from variation across populations of non-GFR determinants affecting the filtration markers used to estimate GFR. We hypothesized that combining multiple filtration markers with non-overlapping non-GFR determinants into a panel GFR could improve eGFR accuracy, extending current recognition that adding cystatin C to serum creatinine improves accuracy. Non-GFR determinants of markers can affect the accuracy of eGFR in two ways: first, increased variability in the non-GFR determinants of some filtration markers among application populations compared to the development population may result in outlying values for those markers. Second, systematic differences in the non-GFR determinants of some markers between application and development populations can lead to biased estimates in the application populations. Here, we propose and evaluate methods for estimating GFR based on multiple markers in applications with potentially higher rates of outlying predictors than in development data. We apply transfer learning to address systematic differences between application and development populations. We evaluated a panel of 8 markers (5 metabolites and 3 low molecular weight proteins) in 3,554 participants from 9 studies. Results show that contamination in two strongly predictive markers can increase imprecision by more than two-fold, but outlier identification with robust estimation can restore precision nearly fully to uncontaminated data. Furthermore, transfer learning can yield similar results with even modest training set sample size. Combining both approaches addresses both sources of error in GFR estimates. Once the laboratory challenge of developing a validated targeted assay for additional metabolites is overcome, these methods can inform the use of a panel eGFR across diverse clinical settings, ensuring accuracy despite differing non-GFR determinants. [ABSTRACT FROM AUTHOR]

Published
2024
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45. A prospective cross-sectional study estimated glomerular filtration rate from creatinine and cystatin C in adults with solid tumors

Author

Costa e Silva, Verônica T., Gil, Luiz A., Jr., Inker, Lesley A., Caires, Renato A., Costalonga, Elerson, Coura-Filho, George, Sapienza, Marcelo T., Castro, Gilberto, Jr., Estevez-Diz, Maria DP., Zanetta, Dirce Maria T., Antonângelo, Leila, Marçal, Lia, Tighiouart, Hocine, Miao, Shiyuan, Mathew, Paul, Levey, Andrew S., and Burdmann, Emmanuel A.

Published
2022
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46. Change in Albuminuria and GFR Slope as Joint Surrogate End Points for Kidney Failure: Implications for Phase 2 Clinical Trials in CKD

Author

Heerspink, Hiddo J.L., Inker, Lesley A., Tighiouart, Hocine, Collier, Willem H., Haaland, Benjamin, Luo, Jiyu, Appel, Gerald B., Chan, Tak Mao, Estacio, Raymond O., Fervenza, Fernando, Floege, Jürgen, Imai, Enyu, Jafar, Tazeen H., Lewis, Julia B., Kam-Tao Li, Philip, Locatelli, Francesco, Maes, Bart D., Perna, Annalisa, Perrone, Ronald D., Praga, Manuel, Schena, Francesco P., Wanner, Christoph, Xie, Di, Greene, Tom, Schrier, Robert W., Hanratty, Rebecca, Maschio, Giuseppe, Carlo, Manno, Saddelli, Mauro, Brenner, Barry M., Lewis, Edmund, von Eynatten, Maximilian, de Jong, Paul E., van Essen, GG, Hou, Fan Fan, Chapman, Arlene, Torres, Vicente, Yu, Alan, Brosnahan, Godela, Chow, Kai-Ming, Szeto, Cheuk-Chun, Leung, Chi-Bon, Hunsicker, Lawrence G., Dwyer, Jamie, Pohl, Marc, Raz, Itamar, Del Vecchio, Lucia, Andrulli, Simeone, Pozzi, Claudio, Casartelli, Donatella, Malfait, Thomas, Vanacker, An, Caravaca-Fontán, Fernando, Trujillo, Hernando, Cavero, Teresa, Gutierrez, Eduardo, Beck, Gerald, Kusek, John, Eknoyan, Garabed, Ponticelli, Claudio, Montagnino, Giuseppe, Passerini, Patrizia, Moroni, Gabriella, Kobayashi, Fumiaki, Makino, Hirofumi, Ito, Sadayoshi, Chan, Juliana CN, Tang, Colin, Gaspari, Flavio, Lesti, Maria Domenica, Gherardi, Giulia, Gamba, Sara, Keane, William, Donadio, James, Rauen, Thomas, Seikrit, Claudia, Wied, Stefanie, Dwyer, Jamie, and Becker, Gavin J.

Published
2023
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47. Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium

Author

Inker, Lesley A, Grams, Morgan E, Levey, Andrew S, Coresh, Josef, Cirillo, Massimo, Collins, John F, Gansevoort, Ron T, Gutierrez, Orlando M, Hamano, Takayuki, Heine, Gunnar H, Ishikawa, Shizukiyo, Jee, Sun Ha, Kronenberg, Florian, Landray, Martin J, Miura, Katsuyuki, Nadkarni, Girish N, Peralta, Carmen A, Rothenbacher, Dietrich, Schaeffner, Elke, Sedaghat, Sanaz, Shlipak, Michael G, Zhang, Luxia, van Zuilen, Arjan D, Hallan, Stein I, Kovesdy, Csaba P, Woodward, Mark, Levin, Adeera, Astor, Brad, Appel, Larry, Greene, Tom, Chen, Teresa, Chalmers, John, Arima, Hisatomi, Perkovic, Vlado, Yatsuya, Hiroshi, Tamakoshi, Koji, Li, Yuanying, Hirakawa, Yoshihisa, Matsushita, Kunihiro, Grams, Morgan, Sang, Yingying, Polkinghorne, Kevan, Chadban, Steven, Atkins, Robert, Djurdjev, Ognjenka, Liu, Lisheng, Zhao, Minghui, Wang, Fang, Wang, Jinwei, Ebert, Natalie, Martus, Peter, Tang, Mila, Heine, Gunnar, Emrich, Insa, Seiler, Sarah, Zawada, Adam, Nally, Joseph, Navaneethan, Sankar, Schold, Jesse, Shlipak, Michael, Sarnak, Mark, Katz, Ronit, Hiramoto, Jade, Iso, Hiroyasu, Yamagishi, Kazumasa, Umesawa, Mitsumasa, Muraki, Isao, Fukagawa, Masafumi, Maruyama, Shoichi, Hasegawa, Takeshi, Fujii, Naohiko, Wheeler, David, Emberson, John, Townend, John, Landray, Martin, Brenner, Hermann, Schöttker, Ben, Saum, Kai-Uwe, Fox, Caroline, Hwang, Shih-Jen, Köttgen, Anna, Schneider, Markus P, Eckardt, Kai-Uwe, Green, Jamie, Kirchner, H Lester, and Chang, Alex R

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Kidney Disease, Women's Health, Renal and urogenital, Good Health and Well Being, Aged, Albuminuria, Blood Chemical Analysis, Creatinine, Cross-Sectional Studies, Disease Progression, Female, Global Health, Glomerular Filtration Rate, Humans, Hypertension, Renal, Internationality, Kidney Function Tests, Male, Middle Aged, Predictive Value of Tests, Renal Insufficiency, Chronic, Retrospective Studies, Sensitivity and Specificity, Severity of Illness Index, Urinalysis, CKD Prognosis Consortium, CKD stage, Chronic kidney disease, albuminuria, anemia, diabetes, glomerular filtration rate, hematocrit, hemoglobin, hyperparathyroidism, hypertension, individual-level meta-analysis, kidney function, laboratory abnormality, laboratory tests, meta-analysis, serum bicarbonate, serum calcium, serum intact parathyroid hormone, serum phosphorus, serum potassium, staging system, Public Health and Health Services, Urology & Nephrology, Clinical sciences
Abstract

Rationale & objectiveChronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework.Study designCross-sectional individual participant-level analyses in a global consortium.Setting & study populations17 CKD and 38 general population and high-risk cohorts.Selection criteria for studiesCohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension.Data extractionData were obtained and analyzed between July 2015 and January 2018.Analytical approachWe modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses.ResultsThe CKD cohorts (n=254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n=1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59mL/min/1.73m2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30mg/g).LimitationsVariations in study era, health care delivery system, typical diet, and laboratory assays.ConclusionsLower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD.

Published
2019

48. Grams ME, Sang Y, Ballew SH, et al, for the Chronic Kidney Disease Prognosis Consortium. Predicting timing of clinical outcomes in patients with chronic kidney disease and severely decreased glomerular filtration rate. Kidney Int. 2018;93:1442–1451

Author

Astor, Brad, Appel, Lawrence J, Levin, Adeera, Tang, Mila, Djurdjev, Ognjenka, Navaneethan, Sankar D, Jolly, Stacey E, Schold, Jesse D, Nally, Joseph V, Wheeler, David C, Emberson, Jonathan, Townend, John, Landray, Martin, Feldman, Harold I, Hsu, Chi-yuan, Lash, James P, Kalra, Philip A, Ritchie, James P, Maharajan, Raman, Middleton, Rachel J, O’Donoghue, Donal J, Eckardt, Kai-Uwe, Schneider, Markus P, Köttgen, Anna, Kronenberg, Florian, Bärthlein, Barbara, Chang, Alex R, Green, Jamie A, Kirchner, H Lester, Ho, Kevin, Marks, Angharad, Black, Corri, Prescott, Gordon J, Fluck, Nick, Nakayama, Masaaki, Miyazaki, Mariko, Yamamoto, Tae, Yamada, Wang, Angela Yee-Moon, Cheung, Sharon, Wong, Sharon, Chu, Jessie, Wu, Henry, Garg, Amit X, McArthur, Eric, Nash, Danielle M, Shalev, Varda, Chodick, Gabriel, Blankestijn, Peter J, Wetzels, Jack FM, van Zuilen, Arjan D, van den Brand, Jan A, Levey, Andrew S, Inker, Lesley A, Sarnak, Mark J, Tighiouart, Hocine, Zhang, Haitao, Stengel, Benedicte, Metzger, Marie, Flamant, Martin, Houillier, Pascal, Haymann, Jean-Philippe, Rios, Pablo G, Mazzuchi, Nelson, Gadola, Liliana, Lamadrid, Verónica, Sola, Laura, Collins, John F, Elley, C Raina, Kenealy, Timothy, Moranne, Olivier, Couchoud, Cecile, Vigneau, Cecile, Brunskill, Nigel J, Major, Rupert W, Shepherd, David, Medcalf, James F, Kovesdy, Csaba P, Kalantar-Zadeh, Kamyar, Molnar, Miklos Z, Sumida, Keiichi, Potukuchi, Praveen K, Heerspink, Hiddo JL, de Zeeuw, Dick, Brenner, Barry, Carrero, Juan Jesus, Gasparini, Alessandro, Qureshi, Abdul Rashid, Elinder, Carl-Gustaf, Visseren, Frank LJ, van der Graaf, Yolanda, Evans, Marie, Stendahl, Maria, Schön, Staffan, Segelmark, Mårten, Prütz, Karl-Göran, Naimark, David M, Tangri, Navdeep, and Mark, Patrick B

Subjects
Renal and urogenital, Chronic Kidney Disease Prognosis Consortium, Clinical Sciences, Urology & Nephrology
Abstract

The Chronic Kidney Disease (CKD) Prognosis Consortium is a collaborative author of the above-mentioned article. The CKD Prognosis Consortium investigators/collaborators are as follows: • African American Study of Kidney Disease and Hypertension (AASK): Brad Astor, Lawrence J. Appel; Canadian Study of Prediction of Death, Dialysis and Interim Cardiovascular Events (CanPREDDICT): Adeera Levin, Mila Tang, Ognjenka Djurdjev; Cleveland Clinic CKD Registry Study (CCF): Sankar D. Navaneethan, Stacey E. Jolly, Jesse D. Schold, Joseph V. Nally Jr.; Chronic Renal Impairment in Birmingham (CRIB): David C. Wheeler, Jonathan Emberson, John Townend, Martin Landray; Chronic Renal Insufficiency Cohort Study (CRIC): Harold I. Feldman, Chi-yuan Hsu, James P. Lash, Lawrence J. Appel; Chronic Renal Insufficiency Standards Implementation Study (CRISIS): Philip A. Kalra, James P. Ritchie, Raman Maharajan, Rachel J. Middleton, Donal J. O'Donoghue; German Chronic Kidney Disease Study (GCKD): Kai-Uwe Eckardt, Markus P. Schneider, Anna Köttgen, Florian Kronenberg, Barbara Bärthlein; Geisinger Health System: Alex R. Chang, Jamie A. Green, H. Lester Kirchner, Kevin Ho; Grampian Laboratory Outcomes, Morbidity and Mortality Studies – 2 (GLOMMS2): Angharad Marks, Corri Black, Gordon J. Prescott, Nick Fluck; Gonryo Study: Masaaki Nakayama, Mariko Miyazaki, Tae Yamamoto, Gen Yamada; Hong Kong CKD Studies: Angela Yee-Moon Wang, Sharon Cheung, Sharon Wong, Jessie Chu, Henry Wu; Ontario Institute for Clinical Evaluative Sciences, Provincial Kidney, Dialysis and Transplantation program (ICES KDT): Amit X. Garg, Eric McArthur, Danielle M. Nash; Maccabi Health System: Varda Shalev, Gabriel Chodick; Multifactorial Approach and Superior Treatment Efficacy in Renal Patients with the Aid of a Nurse Practitioner (MASTERPLAN): Peter J. Blankestijn, Jack F.M. Wetzels, Arjan D. van Zuilen, Jan A. van den Brand; Modification of Diet in Renal Disease Study (MDRD): Andrew S. Levey, Lesley A. Inker, Mark J. Sarnak, Hocine Tighiouart; Nanjing CKD Network Cohort Study (Nanjing CKD): Haitao Zhang; NephroTest Study (NephroTest): Benedicte Stengel, Marie Metzger, Martin Flamant, Pascal Houillier, Jean-Philippe Haymann; National Renal Healthcare Program – Uruguay (NRHP-URU): Pablo G. Rios, Nelson Mazzuchi, Liliana Gadola, Verónica Lamadrid, Laura Sola; New Zealand Diabetes Cohort Study (NZDCS): John F. Collins, C. Raina Elley, Timothy Kenealy; Parcours de Soins des Personnes Agées (PSPA): Olivier Moranne, Cecile Couchoud, Cecile Vigneau; Primary-Secondary Care Partnership to Prevent Adverse Outcomes in Chronic Kidney Disease (PSP CKD): Nigel J. Brunskill, Rupert W. Major, David Shepherd, James F. Medcalf; Racial and Cardiovascular Risk Anomalies in CKD Cohort (RCAV): Csaba P. Kovesdy, Kamyar Kalantar-Zadeh, Miklos Z. Molnar, Keiichi Sumida, Praveen K. Potukuchi; Reduction of Endpoints in Non-insulin Dependent Diabetes Mellitus with the Angiotensin II Antagonist Losartan (RENAAL): Hiddo J.L. Heerspink, Dick de Zeeuw, Barry Brenner; Stockholm CREAtinine Measurements Cohort (SCREAM): Juan Jesus Carrero, Alessandro Gasparini, Abdul Rashid Qureshi, Carl-Gustaf Elinder; Second Manifestations of ARTerial Disease Study (SMART): Frank L.J. Visseren, Yolanda van der Graaf; Swedish Renal Registry CKD Cohort (SRR CKD): Marie Evans, Maria Stendahl, Staffan Schön, Mårten Segelmark, Karl-Göran Prütz; Sunnybrook Cohort: David M. Naimark, Navdeep Tangri; West of Scotland CKD Study: Patrick B. Mark, Jamie P. Traynor, Colin C. Geddes, Peter C. Thomson.• CKD Prognosis Consortium Steering Committee: Alex R. Chang, Josef Coresh (Chair), Ron T. Gansevoort, Morgan E. Grams, Anna Köttgen, Andrew S. Levey, Kunihiro Matsushita, Mark Woodward, Luxia Zhang.• CKD Prognosis Consortium Data Coordinating Center: Shoshana H. Ballew (Assistant Project Director), Jingsha Chen (Programmer), Josef Coresh (Principal Investigator), Morgan E. Grams (Director of Nephrology Initiatives), Lucia Kwak (Programmer), Kunihiro Matsushita (Director), Yingying Sang (Lead Programmer), Aditya Surapaneni (Programmer), Mark Woodward (Senior Statistician).• Kidney Disease Improving Global Outcomes (KDIGO) Controversies Conference on Prognosis and Optimal Management of Patients with Advanced CKD: Kai-Uwe Eckardt (Conference Co-Chair), Brenda R. Hemmelgarn (Conference Co-Chair), David C. Wheeler (KDIGO Co-Chair), Wolfgang C. Winkelmayer (KDIGO Co-Chair), John Davis (CEO), Danielle Green (Managing Director), Michael Cheung (Chief Scientific Officer), Tanya Green (Communications Director), Melissa McMahan (Programs Director).

Published
2018

49. Evans M, Grams ME, Sang Y, et al., for the Chronic Kidney Disease Prognosis Consortium. Risk factors for prognosis in patients with severely decreased GFR. Kidney Int Rep. 2018;3:625–637

Author

Astor, Brad, Appel, Lawrence J, Levin, Adeera, Djurdjev, Ognjenka, Tang, Mila, Navaneethan, Sankar D, Jolly, Stacey E, Schold, Jesse D, Nally, Joseph V, Wheeler, David C, Emberson, Jonathan, Townend, John, Landray, Martin, Feldman, Harold I, Hsu, Chi-yuan, Lash, James P, Kalra, Philip A, Ritchie, James P, Maharajan, Raman, Alderson, Helen, Lane, Beverly, Eckardt, Kai-Uwe, Schneider, Markus P, Köttgen, Anna, Kronenberg, Florian, Bärthlein, Barbara, Chang, Alex R, Green, Jamie A, Kirchner, H Lester, Ho, Kevin, Marks, Angharad, Black, Corri, Prescott, Gordon J, Fluck, Nick, Nakayama, Masaaki, Miyazaki, Mariko, Yamamoto, Tae, Yamada, Wang, Angela Yee-Moon, Cheung, Sharon, Wong, Sharon, Chu, Jessie, Wu, Henry, Shalev, Varda, Chodick, Gabriel, Blankestijn, Peter J, Wetzels, Jack FM, van Zuilen, Arjan D, van den Brand, Jan A, Levey, Andrew S, Inker, Lesley A, Sarnak, Mark J, Tighiouart, Hocine, Zhang, Haitao, Stengel, Benedicte, Rios, Pablo G, Mazzuchi, Nelson, Gadola, Liliana, Lamadrid, Verónica, Sola, Laura, Collins, John F, Elley, C Raina, Kenealy, Timothy, Moranne, Olivier, Couchoud, Cecile, Vigneau, Cecile, Brunskill, Nigel J, Major, Rupert W, Shepherd, David, Medcalf, James F, Kovesdy, Csaba P, Kalantar-Zadeh, Kamyar, Molnar, Miklos Z, Sumida, Keiichi, Potukuchi, Praveen K, Heerspink, Hiddo JL, de Zeeuw, Dick, Brenner, Barry, Carrero, Juan Jesus, Barany, Peter, Qureshi, Abdul Rashid, Elinder, Carl-Gustaf, Visseren, Frank LJ, van der Graaf, Yolanda, Evans, Marie, Stendahl, Maria, Schön, Staffan, Segelmark, Mårten, Prütz, Karl-Göran, Naimark, David M, Tangri, Navdeep, Mark, Patrick B, Traynor, Jamie P, Geddes, Colin C, Thomson, Peter C, and Coresh, Josef

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Renal and urogenital, Good Health and Well Being, Chronic Kidney Disease Prognosis Consortium, Biomedical and clinical sciences, Health sciences
Abstract

[This corrects the article DOI: 10.1016/j.ekir.2018.01.002.].

Published
2018

50. Biological Variability of Estimated GFR and Albuminuria in CKD.

Author

Waikar, Sushrut S, Rebholz, Casey M, Zheng, Zihe, Hurwitz, Shelley, Hsu, Chi-Yuan, Feldman, Harold I, Xie, Dawei, Liu, Kathleen D, Mifflin, Theodore E, Eckfeldt, John H, Kimmel, Paul L, Vasan, Ramachandran S, Bonventre, Joseph V, Inker, Lesley A, Coresh, Josef, and Chronic Kidney Disease Biomarkers Consortium Investigators

Subjects
Chronic Kidney Disease Biomarkers Consortium Investigators, Humans, Albuminuria, Creatinine, Intramolecular Oxidoreductases, beta 2-Microglobulin, Glomerular Filtration Rate, Urinalysis, Blood Chemical Analysis, Prognosis, Severity of Illness Index, Cross-Sectional Studies, Predictive Value of Tests, Adult, Aged, Middle Aged, Female, Male, Renal Insufficiency, Chronic, Lipocalins, Cystatin C, Biomarkers, beta trace protein, biological variability, biomarker, clinically meaningful differences, coefficient of variation, cystatin C, estimated glomerular filtration rate, filtration marker, intraindividual variation, kidney function, laboratory measurement, reproducibility, serum creatinine, urinary albumin-creatinine ratio, β(2)-microglobulin, Kidney Disease, Clinical Research, Renal and urogenital, Good Health and Well Being, Clinical Sciences, Public Health and Health Services, Urology & Nephrology
Abstract

Rationale & objectiveDetermining whether a change in estimated glomerular filtration rate (eGFR) or albuminuria is clinically significant requires knowledge of short-term within-person variability of the measurements, which few studies have addressed in the setting of chronic kidney disease.Study designCross-sectional study with multiple collections over less than 4 weeks.Setting & participantsClinically stable outpatients with chronic kidney disease (N=50; mean age, 56.8 years; median eGFR, 40mL/min/1.73m2; median urinary albumin-creatinine ratio (UACR), 173mg/g).ExposureRepeat measurements from serially collected samples across 3 study visits.OutcomesMeasurements of urine albumin concentration (UAC), UACR, and plasma creatinine, cystatin C, β2-microglobulin (B2M), and beta trace protein (BTP).Analytical approachWe calculated within-person coefficients of variation (CVw) values and corresponding reference change positive and negative (RCVpos and RCVneg) values using log-transformed measurements.ResultsMedian CVw (RCVpos; RCVneg) values of filtration markers were 5.4% (+16%; -14%) for serum creatinine, 4.1% (+12%; -11%) for cystatin C, 7.4% (+23%; -18%) for BTP, and 5.6% (+17%; -14%) for B2M. Results for albuminuria were 33.2% (+145%; -59%) for first-morning UAC, 50.6% (+276%; -73%) for random spot UAC, 32.5% (+141%; -58%) for first-morning UACR, and 29.7% (124%; -55%) for random spot UACR. CVw values for filtration markers were comparable across the range of baseline eGFRs. CVw values for UAC and UACR were comparable across the range of baseline albuminuria values.LimitationsSmall sample size limits the ability to detect differences in variability across markers. Participants were recruited and followed up in a clinical and not research setting, so some preanalytical factors could not be controlled.ConclusionseGFR markers appear to have relatively low short-term within-person variability, whereas variability in albuminuria appears to be high, making it difficult to distinguish random variability from meaningful biologic changes.

Published
2018

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