Article Dans Une Revue Clinical Kidney Journal Année : 2024

Estimating glomerular filtration in young people

1 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
2 CHU Sart Tilman - Centre Hospitalier Universitaire Sart Tilman
3 Hôpital Edouard Herriot [CHU - HCL]
4 Skane University Hospital [Lund]
5 Lund University
6 HEGP - Hôpital Européen Georges Pompidou [APHP]
7 ImmunoConcept - Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle
8 Service de Néphrologie-transplantation-dialyse [Bordeaux]
9 AURAL - Association pour l'Utilisation du Rein Artificiel Région Lyonnaise
10 Service Néphrologie, Hémodialyses [CHU Clermont-Ferrand]
11 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
12 Department of Laboratory Medicine [Karolinska Institutet]
13 Karolinska University Hospital [Stockholm]
14 Département de Néphrologie et Transplantation d'organes [CHU Toulouse]
15 SFR-BMT - Structure Fédérative de Recherche Bio-Médicale de Toulouse
16 Hôpital Necker - Enfants Malades [AP-HP]
17 UPCité - Université Paris Cité
18 Service de Néphrologie Dialyse, Transplantation rénale [CHU Saint Etienne]
19 CHUGA - CHU de Grenoble-Alpes - Centre Hospitalier Universitaire CHU Grenoble
20 Mayo Clinic [Rochester]
21 Örebro University Hospital [Örebro, Sweden]
22 VU - Vrije Universiteit Amsterdam [Amsterdam]
23 Amsterdam UMC - Amsterdam University Medical Centers
24 Karolinska Institutet = Karolinska Institute [Stockholm]
25 Uppsala University
26 KU Leuven - Catholic University of Leuven = Katholieke Universiteit Leuven
Laurence Derain Dubourg
Anders Grubb
Andrew Rule
Anders Larsson
Ulf Nyman

Résumé

Background. Creatinine-based equations are the most used to estimate glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the re-expressed Lund-Malmö Revised (r-LMR) and the European Kidney Function Consortium (EKFC) equations are the most validated. The EKFC and r-LMR equations have been suggested to have better performances in young adults, but this is debated. Methods: We collected data (GFR) measured by clearance of an exogenous marker (reference method), serum creatinine, age and sex from 2366 young adults (aged between 18 and 25 years) both from Europe and the USA. Results: In the European cohorts (n = 1892), the bias (in mL/min/1.73 m²) was systematically better for the EKFC and r-LMR equations compared with the CKD-EPI equation [2.28, 95% confidence interval (1.59; 2.91), –2.50 (–3.85; –1.76), 17.41 (16.49; 18.47), respectively]. The percentage of estimated GFR within 30% of measured GFR (P30) was also better for EKFC and r-LMR equations compared with the CKD-EPI equation [84.4% (82.8; 86.0), 87.2% (85.7; 88.7) and 65.4% (63.3; 67.6), respectively]. In the US cohorts (n = 474), the bias for the EKFC and r-LMR equations was better than for the CKD-EPI equation in the non-Black population [0.97 (–1.69; 3.06), –2.62 (–5.14; –1.43) and 7.74 (5.97; 9.63), respectively], whereas the bias was similar in Black US individuals. P30 results were not different between the three equations in US cohorts. Analyses in sub-populations confirmed these results, except in individuals with high GFR levels (GFR ≥120 mL/min/1.73 m²) for whom the CKD-EPI equation might have a lower bias. Conclusions. We demonstrated that both the EKFC and r-LMR creatinine-based equations have a better performance than the CKD-EPI equation in a young population. The only exception might be in patients with hyperfiltration.

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hal-04926133 , version 1 (03-02-2025)

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Pierre Delanaye, Laurence Derain Dubourg, Jonas Björk, Marie Courbebaisse, Lionel Couzi, et al.. Estimating glomerular filtration in young people. Clinical Kidney Journal, 2024, 17 (9), ⟨10.1093/ckj/sfae261⟩. ⟨hal-04926133⟩
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