Kidney Week

Abstract: TH-PO1032

Performance of the European Kidney Function Consortium (EKFC) Creatinine-Based Equation in American Cohorts

Session Information

• CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Delanaye, Pierre, Universite de Liege, Liege, Belgium

Pierre Delanaye,

• Rule, Andrew D., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Andrew D. Rule,

• Schaeffner, Elke, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany

Elke Schaeffner,

• Cavalier, Etienne, Universite de Liege, Liege, Belgium

Etienne Cavalier,

• Nyman, Ulf, Lunds Universitet, Lund, Sweden

Ulf Nyman,

• Björk, Jonas, Lunds Universitet, Lund, Sweden

Jonas Björk,

• Pottel, Hans, Universite de Liege, Liege, Belgium

Hans Pottel,

Group or Team Name

• EKFC (European Kidney Function Consortium).

Background

The new creatinine-based European Kidney Function Consortium (EKFC) equation has been developed and validated in datasets of European subjects. This equation is based on rescaled creatinine, with the rescaling factor (Q-value) which is the median normal value of serum creatinine in a given population. The EKFC equation performed well across the whole age spectrum. However, the validation was limited in Black and non-Black Americans.

Methods

Cross-sectional analysis with separate pooled datasets for validation from 9 US research and clinical studies with measured GFR, age, sex, and self-reported race available. Two strategies were considered with population specific Q-values in Black and non-Black men and women (EKFC_PS) or a race-free Q value (EKFC_RF) which is the mean of the Q values obtained in Black and non-black populations. Performance (bias, precision and accuracy within 30% (P30) was compared with the CKD-EPI₂₀₂₁ equation.

Results

In the whole adult population (n=12,854), the EKFC_PS equation showed no statistical bias (0.14 95%CI [-0.07;0.35] mL/min/1.73m2), and the statistical bias of the EKFC_RF (0.74 [0.51;0.94] mL/min/1.73m2) was closer to zero than the CKD-EPI₂₀₂₁ equation (1.22 [0.99;1.47]) mL/min/1.73m2]. The percentage of estimated GFR within 30% of measured GFR was similar for CKD-EPI₂₀₂₁ (79.2% [78.5%-79.9%]) and EKFC_RF (80.1% [79.4%-80.7%]) but improved with the EKFC_PS equation (81.1% [80.5%-81.8%]).

Conclusion

The EKFC-equation can be used in the USA to estimate GFR incorporating either self-reported race or unknown race at the patient’s discretion per hospital registration records. The performance of the EKFC equation is as at least good as the CKD-EPI₂₀₂₁ equation.