Kidney Week

Abstract: FR-PO938

Validation of a Multimarker eGFR Equation in Preserved and Reduced eGFR Using the GENOA Cohort

Session Information

• CKD Epidemiology, Risk Factors, Prevention - II
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Tio, Maria Clarissa, University of Mississippi Medical Center, Jackson, Mississippi, United States

Maria Clarissa Tio,

• Zhu, Xiaoqian, University of Mississippi Medical Center, Jackson, Mississippi, United States

Xiaoqian Zhu,

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

Andrew D. Rule,

• Lirette, Seth, University of Mississippi Medical Center, Jackson, Mississippi, United States

Seth Lirette,

• Obi, Yoshitsugu, University of Mississippi Medical Center, Jackson, Mississippi, United States

Yoshitsugu Obi,

• Yen, Timothy E., University of Mississippi Medical Center, Jackson, Mississippi, United States

Timothy E. Yen,

• Hall, Michael, University of Mississippi Medical Center, Jackson, Mississippi, United States

Michael Hall,

• Dossabhoy, Neville R., University of Mississippi Medical Center, Jackson, Mississippi, United States

Neville R. Dossabhoy,

• Shafi, Tariq, Houston Methodist, Houston, Texas, United States

Tariq Shafi,

Background

Performance of the race-free CKD-EPI 2021 equation varies with severity of kidney disease. We sought to examine the performance of a novel multimarker eGFR panel (panel-eGFR) among Black and White persons stratified by eGFR categories using the biracial Genetic Epidemiology Network of Arteriopathy (GENOA) cohort.

Methods

We included 224 sex, race/ethnicity, and measured GFR (mGFR)-category-matched persons. GFR was measured using urinary clearance of iothalamate. Panel-eGFR was calculated using serum creatinine, valine, myo-inositol, cystatin C, age, and sex. All GFR’s are presented as mL/min/1.73 m². We compared panel-eGFR’s reliability to the 2021 CKD-EPI creatinine and cystatin C (eGFR-Cr-CysC) equation using bias, precision, and accuracy metrics between race (Black vs. White participants) and eGFR (eGFR-Cr-CysC≥60 or preserved eGFR vs. <60 or reduced eGFR) subgroups.

Results

In the overall cohort, 49% were Black individuals and 79% had eGFR-Cr-CysC≥60. Among those with preserved eGFR, eGFR-Cr-CysC was lower than mGFR by 5.6 and 6.6 among Black and White participants, respectively. In contrast, panel eGFR was unbiased among Black (bias: -0.5; 95% CI: -2.8, 2.9) and White participants (bias: -0.4; 95% CI: -5.6, 4.5) with preserved eGFR. Among those with reduced eGFR, eGFR-Cr-CysC was unbiased among Black and White participants. Conversely, panel-eGFR was higher than mGFR in both Black (bias: -9.8; 95% CI: -11.8, -3.1) and White (bias: -6.3; 95% CI: -9.0, -3.7) participants with reduced eGFR. P30 for panel-eGFR among Black participants with reduced eGFR was 70%. Otherwise, P30 metric was acceptable (>80%) for both equations across race and eGFR subgroups.

Conclusion

A novel panel-eGFR performs better than the current eGFR-Cr-CysC equation among persons with preserved eGFR, and this is consistent between Black and White persons.

Funding

• Other U.S. Government Support