Estimating glomerular filtration in young people

Pierre Delanaye; Laurence Derain-Dubourg; Jonas Björk; Marie Courbebaisse; Lionel Couzi; Francois Gaillard; Cyril Garrouste; Anders Grubb; Lola Jacquemont; Magnus Hansson; Nassim Kamar; Christophe Legendre; Karin Littmann; Christophe Mariat; Lionel Rostaing; Andrew D Rule; Per-Ola Sundin; Arend Bökenkamp; Ulla Berg; Kajsa Åsling-Monemi; Anna Åkesson; Anders Larsson; Ulf Nyman; Hans Pottel

doi:10.1093/ckj/sfae261

Estimating glomerular filtration in young people

Pierre Delanaye, Laurence Derain-Dubourg, Jonas Björk, Marie Courbebaisse, Lionel Couzi, Francois Gaillard, Cyril Garrouste, Anders Grubb, Lola Jacquemont, Magnus Hansson, Nassim Kamar, Christophe Legendre, Karin Littmann, Christophe Mariat, Lionel Rostaing, Andrew D Rule, Per-Ola Sundin, Arend Bökenkamp, Ulla Berg, Kajsa Åsling-MonemiAnna Åkesson, Anders Larsson, Ulf Nyman, Hans Pottel

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malmö Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated.

METHODS: We collected data (GFR) measured by clearance of an exogenous marker (reference method), serum creatinine, age and sex from 2366 young adults (aged between 18 and 25 years) both from Europe and the USA.

RESULTS: In the European cohorts (n = 1892), the bias (in mL/min/1.73 m²) was systematically better for the EKFC and r-LMR equations compared with the CKD-EPI equation [2.28, 95% confidence interval (1.59; 2.91), -2.50 (-3.85; -1.76), 17.41 (16.49; 18.47), respectively]. The percentage of estimated GFR within 30% of measured GFR (P30) was also better for EKFC and r-LMR equations compared with the CKD-EPI equation [84.4% (82.8; 86.0), 87.2% (85.7; 88.7) and 65.4% (63.3; 67.6), respectively]. In the US cohorts (n = 474), the bias for the EKFC and r-LMR equations was better than for the CKD-EPI equation in the non-Black population [0.97 (-1.69; 3.06), -2.62 (-5.14; -1.43) and 7.74 (5.97; 9.63), respectively], whereas the bias was similar in Black US individuals. P30 results were not different between the three equations in US cohorts. Analyses in sub-populations confirmed these results, except in individuals with high GFR levels (GFR ≥120 mL/min/1.73 m²) for whom the CKD-EPI equation might have a lower bias.

CONCLUSIONS: We demonstrated that both the EKFC and r-LMR creatinine-based equations have a better performance than the CKD-EPI equation in a young population. The only exception might be in patients with hyperfiltration.

Original language	English
Pages (from-to)	fae261
Journal	Clinical Kidney Journal
Volume	17
Issue number	9
DOIs	https://doi.org/10.1093/ckj/sfae261
Publication status	Published - 2024 Sept

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Clinical Medicine

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10.1093/ckj/sfae261Licence: CC BY

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Delanaye, P., Derain-Dubourg, L., Björk, J., Courbebaisse, M., Couzi, L., Gaillard, F., Garrouste, C., Grubb, A., Jacquemont, L., Hansson, M., Kamar, N., Legendre, C., Littmann, K., Mariat, C., Rostaing, L., Rule, A. D., Sundin, P.-O., Bökenkamp, A., Berg, U., ... Pottel, H. (2024). Estimating glomerular filtration in young people. Clinical Kidney Journal, 17(9), fae261. https://doi.org/10.1093/ckj/sfae261

@article{52f8c028e430455fa328b7cc264c5151,

title = "Estimating glomerular filtration in young people",

abstract = "BACKGROUND: Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malm{\"o} Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated.METHODS: We collected data (GFR) measured by clearance of an exogenous marker (reference method), serum creatinine, age and sex from 2366 young adults (aged between 18 and 25 years) both from Europe and the USA.RESULTS: In the European cohorts (n = 1892), the bias (in mL/min/1.73 m²) was systematically better for the EKFC and r-LMR equations compared with the CKD-EPI equation [2.28, 95% confidence interval (1.59; 2.91), -2.50 (-3.85; -1.76), 17.41 (16.49; 18.47), respectively]. The percentage of estimated GFR within 30% of measured GFR (P30) was also better for EKFC and r-LMR equations compared with the CKD-EPI equation [84.4% (82.8; 86.0), 87.2% (85.7; 88.7) and 65.4% (63.3; 67.6), respectively]. In the US cohorts (n = 474), the bias for the EKFC and r-LMR equations was better than for the CKD-EPI equation in the non-Black population [0.97 (-1.69; 3.06), -2.62 (-5.14; -1.43) and 7.74 (5.97; 9.63), respectively], whereas the bias was similar in Black US individuals. P30 results were not different between the three equations in US cohorts. Analyses in sub-populations confirmed these results, except in individuals with high GFR levels (GFR ≥120 mL/min/1.73 m²) for whom the CKD-EPI equation might have a lower bias.CONCLUSIONS: We demonstrated that both the EKFC and r-LMR creatinine-based equations have a better performance than the CKD-EPI equation in a young population. The only exception might be in patients with hyperfiltration.",

author = "Pierre Delanaye and Laurence Derain-Dubourg and Jonas Bj{\"o}rk and Marie Courbebaisse and Lionel Couzi and Francois Gaillard and Cyril Garrouste and Anders Grubb and Lola Jacquemont and Magnus Hansson and Nassim Kamar and Christophe Legendre and Karin Littmann and Christophe Mariat and Lionel Rostaing and Rule, {Andrew D} and Per-Ola Sundin and Arend B{\"o}kenkamp and Ulla Berg and Kajsa {\AA}sling-Monemi and Anna {\AA}kesson and Anders Larsson and Ulf Nyman and Hans Pottel",

note = "{\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.",

year = "2024",

month = sep,

doi = "10.1093/ckj/sfae261",

language = "English",

volume = "17",

pages = "fae261",

journal = "Clinical Kidney Journal",

issn = "2048-8505",

publisher = "Oxford University Press",

number = "9",

}

Delanaye, P, Derain-Dubourg, L, Björk, J, Courbebaisse, M, Couzi, L, Gaillard, F, Garrouste, C, Grubb, A, Jacquemont, L, Hansson, M, Kamar, N, Legendre, C, Littmann, K, Mariat, C, Rostaing, L, Rule, AD, Sundin, P-O, Bökenkamp, A, Berg, U, Åsling-Monemi, K, Åkesson, A, Larsson, A, Nyman, U & Pottel, H 2024, 'Estimating glomerular filtration in young people', Clinical Kidney Journal, vol. 17, no. 9, pp. fae261. https://doi.org/10.1093/ckj/sfae261

TY - JOUR

T1 - Estimating glomerular filtration in young people

AU - Delanaye, Pierre

AU - Derain-Dubourg, Laurence

AU - Björk, Jonas

AU - Courbebaisse, Marie

AU - Couzi, Lionel

AU - Gaillard, Francois

AU - Garrouste, Cyril

AU - Grubb, Anders

AU - Jacquemont, Lola

AU - Hansson, Magnus

AU - Kamar, Nassim

AU - Legendre, Christophe

AU - Littmann, Karin

AU - Mariat, Christophe

AU - Rostaing, Lionel

AU - Rule, Andrew D

AU - Sundin, Per-Ola

AU - Bökenkamp, Arend

AU - Berg, Ulla

AU - Åsling-Monemi, Kajsa

AU - Åkesson, Anna

AU - Larsson, Anders

AU - Nyman, Ulf

AU - Pottel, Hans

PY - 2024/9

Y1 - 2024/9

N2 - BACKGROUND: Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malmö Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated.METHODS: We collected data (GFR) measured by clearance of an exogenous marker (reference method), serum creatinine, age and sex from 2366 young adults (aged between 18 and 25 years) both from Europe and the USA.RESULTS: In the European cohorts (n = 1892), the bias (in mL/min/1.73 m²) was systematically better for the EKFC and r-LMR equations compared with the CKD-EPI equation [2.28, 95% confidence interval (1.59; 2.91), -2.50 (-3.85; -1.76), 17.41 (16.49; 18.47), respectively]. The percentage of estimated GFR within 30% of measured GFR (P30) was also better for EKFC and r-LMR equations compared with the CKD-EPI equation [84.4% (82.8; 86.0), 87.2% (85.7; 88.7) and 65.4% (63.3; 67.6), respectively]. In the US cohorts (n = 474), the bias for the EKFC and r-LMR equations was better than for the CKD-EPI equation in the non-Black population [0.97 (-1.69; 3.06), -2.62 (-5.14; -1.43) and 7.74 (5.97; 9.63), respectively], whereas the bias was similar in Black US individuals. P30 results were not different between the three equations in US cohorts. Analyses in sub-populations confirmed these results, except in individuals with high GFR levels (GFR ≥120 mL/min/1.73 m²) for whom the CKD-EPI equation might have a lower bias.CONCLUSIONS: We demonstrated that both the EKFC and r-LMR creatinine-based equations have a better performance than the CKD-EPI equation in a young population. The only exception might be in patients with hyperfiltration.

AB - BACKGROUND: Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malmö Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated.METHODS: We collected data (GFR) measured by clearance of an exogenous marker (reference method), serum creatinine, age and sex from 2366 young adults (aged between 18 and 25 years) both from Europe and the USA.RESULTS: In the European cohorts (n = 1892), the bias (in mL/min/1.73 m²) was systematically better for the EKFC and r-LMR equations compared with the CKD-EPI equation [2.28, 95% confidence interval (1.59; 2.91), -2.50 (-3.85; -1.76), 17.41 (16.49; 18.47), respectively]. The percentage of estimated GFR within 30% of measured GFR (P30) was also better for EKFC and r-LMR equations compared with the CKD-EPI equation [84.4% (82.8; 86.0), 87.2% (85.7; 88.7) and 65.4% (63.3; 67.6), respectively]. In the US cohorts (n = 474), the bias for the EKFC and r-LMR equations was better than for the CKD-EPI equation in the non-Black population [0.97 (-1.69; 3.06), -2.62 (-5.14; -1.43) and 7.74 (5.97; 9.63), respectively], whereas the bias was similar in Black US individuals. P30 results were not different between the three equations in US cohorts. Analyses in sub-populations confirmed these results, except in individuals with high GFR levels (GFR ≥120 mL/min/1.73 m²) for whom the CKD-EPI equation might have a lower bias.CONCLUSIONS: We demonstrated that both the EKFC and r-LMR creatinine-based equations have a better performance than the CKD-EPI equation in a young population. The only exception might be in patients with hyperfiltration.

U2 - 10.1093/ckj/sfae261

DO - 10.1093/ckj/sfae261

M3 - Article

C2 - 39314869

SN - 2048-8505

VL - 17

SP - fae261

JO - Clinical Kidney Journal

JF - Clinical Kidney Journal

IS - 9

ER -

Estimating glomerular filtration in young people

Abstract

Bibliographical note

Subject classification (UKÄ)

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