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Kidney Week

Abstract: TH-PO440

Impact of the 2021 Glomerular Filtration Rate Estimation Equation in a Cohort of White Polycystic Kidney Disease Patients

Session Information

Category: Genetic Diseases of the Kidneys

  • 1201 Genetic Diseases of the Kidneys: Cystic

Authors

  • Caliskan, Yasar, Saint Louis University School of Medicine, Saint Louis, Missouri, United States
  • Ozkok, Abdullah, Yeditepe Universitesi, Istanbul, İstanbul, Turkey
  • Alpay Kanitez, Nilüfer, Koc Universitesi, Istanbul, Istanbul, Turkey
  • Oto, Ozgur Akin, Istanbul Universitesi, Fatih, Istanbul, Turkey
  • Mirioglu, Safak, Istanbul Universitesi, Fatih, Istanbul, Turkey
  • Artan, Serra, Istanbul Universitesi, Fatih, Istanbul, Turkey
  • Dirim, Ahmet Burak, Istanbul Universitesi, Fatih, Istanbul, Turkey
  • Edwards, John C., Saint Louis University School of Medicine, Saint Louis, Missouri, United States
  • Yazici, Halil, Istanbul Universitesi, Fatih, Istanbul, Turkey
  • Lentine, Krista L., Saint Louis University School of Medicine, Saint Louis, Missouri, United States
Background

New estimated glomerular filtration rate (eGFR) equations removed race adjustment, but the impact of this removal on prediction of chronic kidney disease (CKD) staging for autosomal dominant Polycystic Kidney Disease (ADPKD) patients is unknown. We aimed to investigate the impact of new eGFR equations on CKD staging and their associations with clinical characteristics in ADPKD patients.

Methods

We examined data for 288 consecutive White patients with ADPKD [mean age 53±16; 158 (54.9%) women, 130 (45.1%) man] through chart review between 2000-2013 with a median 9-yr follow-up (IQR, 6-12 yrs). We computed changes in eGFR resulting from substituting the CKD-EPI 2009 equation for the 2021 equation and the consequent reclassification into different CKD Stages according to KDIGO 2012 classification. Correlates of eGFR changes during follow up are also studied.

Results

Compared to the 2009 equation, CKD-EPI 2021 yielded a higher baseline eGFR, with a median of 2.67 mL/min/1.73 m2 (IQR 1.43-3.43) and higher last visit eGFR with a median 2.64 mL/min/1.73 m2 (IQR 1.24-3.65). Among the cohort of ADPKD patients, 9% (n=26) were reclassified into a higher category of eGFR, as were the following proportions by baseline (2009 equation) stage: from CKD stage 2, 9.1% (n=6) from CKD stage 3, 9.4% (n=3) from stage 4 and 12.8% (n=6) from stage 5. No patient was re-classified into a more severe CKD stage. Based on last visit eGFR, CKD stage was also reclassified into a higher category in 13.3% (n=6) from CKD stage 2, 12.5% (n=6) from stage 3, 10% (n=2) from stage 4 and 7.9% (n=3) from stage 5. The median change in eGFR over median 9 years (follow-up - baseline value) calculated by CKD-EPI 2009 and CKD-EPI 2021 was -8.5 mL/min/1.73 m2 (IQR 0.5-22.1) and -7.9 mL/min/1.73 m2(IQR 0.5-22.7), respectively. Among the baseline clinical characteristics, smoking was significantly correlated with eGFR decline during follow up (CKD-EPI 2009, r=0.0186, p=0.016; CKD-EPI 2021, r=0.186, p=0.018).

Conclusion

Implementing the CKD-EPI 2021 equation in a Caucasian ADPKD population, would increase eGFR by a modest amount. A significant proportion of the population would be re-classified into a higher eGFR category, with a consequent decrease in the prevalence of stage 5 CKD.