Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 39 (2), 205-208

Estimated Glomerular Filtration Rates Show Minor but Significant Differences Between the Single and Subgroup Creatinine-Based Chronic Kidney Disease Epidemiology Collaboration Equations

Affiliations

Estimated Glomerular Filtration Rates Show Minor but Significant Differences Between the Single and Subgroup Creatinine-Based Chronic Kidney Disease Epidemiology Collaboration Equations

Sholhui Park et al. Ann Lab Med.

Abstract

The creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation can be calculated according to race, sex, and creatinine concentration (subgroup equation) or in the form expressed by one equation (single equation). Minor differences in the constants used in the CKD-EPI equations (subgroup vs single equations) could result in a significant difference in the estimated glomerular filtration rate (eGFR). We evaluated the impact of this difference in 79,709 Korean patients. The eGFR was calculated as an integer using the single and subgroup CKD-EPI equations. The differences in eGFR and GFR categories between the equations were analyzed. eGFR was higher in the subgroup equation than the single equation by 1 mL/min/1.73 m² for 12,476 (27.4%) Korean females. The GFR category based on the subgroup equation was reclassified using the single equation for 352 (0.77%) females. Based on the results, the constant of the single equation was optimized. There was no difference in eGFR values between equations using a multiplier of 1.0213 instead of 1.018 for the "white or other" females constant in the single CKD-EPI equation. Clinicians should carefully apply the CKD-EPI equation because eGFR values may differ by 1 mL/min/1.73 m² depending on the manner of calculation. To minimize these differences, the constants of the single equation should be revised.

Keywords: Constant modification; Creatinine-based Chronic Kidney Disease Epidemiology Collaboration equation; Glomerular filtration rate.

Conflict of interest statement

No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1
Fig. 1. Distribution of GFR category according to the creatinine-based CKD-EPI equation in females. The overall agreement between the subgroup and single equations was 99.2% (weighted kappa, 0.990; 95% confidence interval, 0.989–0.991). (A) When using the single equation with the constant 1.018, the GFR categories of 352 (0.77%, 352/45,560) patients were reclassified. (B) The use of 1.0213 rather than 1.018 eliminated the difference in eGFR. *GFR=141×min (Scr/κ, 1)α×max (Scr/κ, 1)−1.209×(0.993)Age×1.018 [if female]×1.159 [if black]; GFR=141×min (Scr/κ, 1)α×max (Scr/κ, 1)−1.209×(0.993)Age×1.0213 [if female]×1.159 [if black].
Abbreviations: CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration; eGFR, estimated glomerular filtration rate; G1, ≥90; G2, 60–89; G3a, 45–59; G3b, 30–44; G4, 15–29; G5,<15 mL/min/1.73 m2; GFR, glomerular filtration rate.

Similar articles

See all similar articles

References

    1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Inter Suppl. 2013;3:1–150.
    1. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604–612. - PMC - PubMed
    1. Ko DH, Lee SW, Hyun J, Kim HS, Park MJ, Shin DH. Proposed imprecision quality goals for urinary albumin/creatinine ratio. Ann Lab Med. 2018;38:420–424. - PMC - PubMed
    1. Katzmann JA. Serum free light chain specificity and sensitivity: a reality check. Clin Chem. 2006;52:1638–1639. - PubMed
    1. Jeong TD, Cho EJ, Ko DH, Lee W, Chun S, Kwon HJ, et al. A new strategy for calculating the risk of ovarian malignancy algorithm (ROMA) Clin Chem Lab Med. 2017;55:1209–1214. - PubMed
Feedback