Prospects for improved glomerular filtration rate estimation based on creatinine—results from a transnational multicentre study

Research output: Contribution to journalArticle


The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved.MethodsIn a cross-sectional analysis covering the years 2003–17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund–Malmö revised equation (LMR) and the Full Age Spectrum equation.Results7In patients aged 18–39 years old, CKD-EPI overestimated GFR with 5.0–16 mL/min/1.73 m2 in median in both cohort types at mGFR levels <120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%.ConclusionsNone of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.


  • Marie Courbebaisse
  • Lionel Couzi
  • R Neil Dalton
  • Laurence Dubourg
  • Natalie Ebert
  • Bjørn Odvar Eriksen
  • Francois Gaillard
  • Cyril Garrouste
  • Magnus Hansson
  • Lola Jacquemont
  • Ian Jones
  • Nassim Kamar
  • Edmund J. Lamb
  • Christophe Legendre
  • Karin Littmann
  • Christophe Mariat
  • Toralf Melsom
  • Lionel Rostaing
  • Andrew D. Rule
  • Elke Schaeffner
  • Per-Ola Sundin
  • Stephen Turner
  • Pierre Delanaye
  • Hans Pottel
External organisations
  • Paris Descartes University
  • University of Bordeaux
  • Evelina London Children's Healthcare
  • Assistance Publique des Hôpitaux de Paris
  • Clermont-Ferrand University Hospital
  • University of Nantes
  • Université Paul Sabatier
  • Örebro University
  • Kliniska Studier Sverige, Forum söder
  • Hôpital Edouard Herriot
  • Charité - University Medicine Berlin
  • Karolinska University Hospital
  • Örebro University Hospital
  • Great Ormond Street Hospital
  • Mayo Clinic Minnesota
  • University of Liège
  • University of Liège Hospital
  • Catholic University of Leuven
  • Hopital Nord CHU de Sainte-Etienne
  • UiT The Arctic University of Norway, Tromsø
  • Grenoble University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Urology and Nephrology
Original languageEnglish
Pages (from-to)674-683
Number of pages10
JournalClinical Kidney Journal
Issue number4
Publication statusPublished - 2020 Jun 13
Publication categoryResearch

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