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

Authors :
Inker, Lesley A
Levey, Andrew S
Tighiouart, Hocine
Shafi, Tariq
Eckfeldt, John H
Johnson, Craig
Okparavero, Aghogho
Post, Wendy S
Coresh, Josef
Shlipak, Michael G
Source :
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association-European Renal Association, vol 33, iss 3
Publication Year :
2018
Publisher :
eScholarship, University of California, 2018.

Abstract

BackgroundThe 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.MethodsIn 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.ResultsAmong 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.ConclusionThe 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.

Details

Database :
OpenAIRE
Journal :
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association-European Renal Association, vol 33, iss 3
Accession number :
edsair.od.......325..b9a4cae6d02615d3d578f05a5c1e3423