Validation of the EKFC equation for glomerular filtration rate estimation and comparison with the Asian-modified CKD-EPI equation in Chinese chronic kidney disease patients in an external study
Objectives The aim of this study is to determine whether new European Kidney Function Consortium (EKFC) equation is more applicable than Asian-modified CKD-EPI equation in clinical practice, having a higher accuracy in estimating GFR in our external CKD population.Methods We calculated estimated GFR...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2150217 |
| _version_ | 1826900409843712000 |
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| author | Li Zhao Huan-li Li Hui-jing Liu Jin Ma Wei Liu Jian-min Huang Ling-ge Wei Peng Xie |
| author_facet | Li Zhao Huan-li Li Hui-jing Liu Jin Ma Wei Liu Jian-min Huang Ling-ge Wei Peng Xie |
| author_sort | Li Zhao |
| collection | DOAJ |
| description | Objectives The aim of this study is to determine whether new European Kidney Function Consortium (EKFC) equation is more applicable than Asian-modified CKD-EPI equation in clinical practice, having a higher accuracy in estimating GFR in our external CKD population.Methods We calculated estimated GFREKFC and GFRCKD-EPI independently using the EKFC and Asian-modified CKD-EPI formulas, respectively. The clinical diagnostic performance of the two equations was assessed and compared by median bias, precision, accuracy (P30) and so on, using 99mTc-DTPA dual plasma sample clearance method as a reference method for GFR measurement (mGFR). The equation that met the following targets was superior: (1) median bias within ± 3 mL/min/1.73 m2; (2) P30 > 75%; and (3) better precision and 95% limits of agreement in Bland–Altman analysis.Results Totally, 160 CKD patients were recruited in our external cohort. GFREKFC was highly related to mGFR, with a regression equation of GFREKFC=mGFR × 0.87 + 5.27. Compared with the Asian-modified CKD-EPI equation, EKFC equation demonstrated a wider median bias (–1.64 vs. 0.84 mL/min/1.73 m2, p < 0.01) that was within 3 mL/min/1.73 m2 and not clinically meaningful. Furthermore, the precision (12.69 vs. 12.72 mL/min/1.73 m2, p = 0.42), 95% limits of agreement in Bland–Altman analysis (42.4 vs. 44.4 mL/min/1.73 m2) and incorrect reclassification index of the two target equations were almost identical. Although, EKFC equation had a slightly better P30 (80.0% vs. 74.4%, p = 0.01).Conclusions The overall performance of EKFC equation is acceptable. There is no clinically meaningful difference in the performance of the Asian-modified CKD-EPI and EKFC equations within the limits imposed by the small sample size. |
| first_indexed | 2024-03-11T18:00:36Z |
| format | Article |
| id | doaj.art-f3f1216cddd34670b4937863668c2af3 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2025-02-17T07:08:13Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-f3f1216cddd34670b4937863668c2af32025-01-06T03:21:19ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2022.2150217Validation of the EKFC equation for glomerular filtration rate estimation and comparison with the Asian-modified CKD-EPI equation in Chinese chronic kidney disease patients in an external studyLi Zhao0Huan-li Li1Hui-jing Liu2Jin Ma3Wei Liu4Jian-min Huang5Ling-ge Wei6Peng Xie7Department of Laboratory Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, PR ChinaDepartment of ophthalmology Medicine, Hebei General Hospital, Shijiazhuang, PR ChinaDepartment of Laboratory Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, PR ChinaDepartment of Laboratory Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, PR ChinaDepartment of Laboratory Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, PR ChinaDepartment of Nuclear Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, PR ChinaDepartment of Nuclear Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, PR ChinaDepartment of Nuclear Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, PR ChinaObjectives The aim of this study is to determine whether new European Kidney Function Consortium (EKFC) equation is more applicable than Asian-modified CKD-EPI equation in clinical practice, having a higher accuracy in estimating GFR in our external CKD population.Methods We calculated estimated GFREKFC and GFRCKD-EPI independently using the EKFC and Asian-modified CKD-EPI formulas, respectively. The clinical diagnostic performance of the two equations was assessed and compared by median bias, precision, accuracy (P30) and so on, using 99mTc-DTPA dual plasma sample clearance method as a reference method for GFR measurement (mGFR). The equation that met the following targets was superior: (1) median bias within ± 3 mL/min/1.73 m2; (2) P30 > 75%; and (3) better precision and 95% limits of agreement in Bland–Altman analysis.Results Totally, 160 CKD patients were recruited in our external cohort. GFREKFC was highly related to mGFR, with a regression equation of GFREKFC=mGFR × 0.87 + 5.27. Compared with the Asian-modified CKD-EPI equation, EKFC equation demonstrated a wider median bias (–1.64 vs. 0.84 mL/min/1.73 m2, p < 0.01) that was within 3 mL/min/1.73 m2 and not clinically meaningful. Furthermore, the precision (12.69 vs. 12.72 mL/min/1.73 m2, p = 0.42), 95% limits of agreement in Bland–Altman analysis (42.4 vs. 44.4 mL/min/1.73 m2) and incorrect reclassification index of the two target equations were almost identical. Although, EKFC equation had a slightly better P30 (80.0% vs. 74.4%, p = 0.01).Conclusions The overall performance of EKFC equation is acceptable. There is no clinically meaningful difference in the performance of the Asian-modified CKD-EPI and EKFC equations within the limits imposed by the small sample size.https://www.tandfonline.com/doi/10.1080/0886022X.2022.2150217Chronic kidney disease (CKD)glomerular filtration rate (GFR)EKFC equationAsian-modified CKD-EPI equation |
| spellingShingle | Li Zhao Huan-li Li Hui-jing Liu Jin Ma Wei Liu Jian-min Huang Ling-ge Wei Peng Xie Validation of the EKFC equation for glomerular filtration rate estimation and comparison with the Asian-modified CKD-EPI equation in Chinese chronic kidney disease patients in an external study Renal Failure Chronic kidney disease (CKD) glomerular filtration rate (GFR) EKFC equation Asian-modified CKD-EPI equation |
| title | Validation of the EKFC equation for glomerular filtration rate estimation and comparison with the Asian-modified CKD-EPI equation in Chinese chronic kidney disease patients in an external study |
| title_full | Validation of the EKFC equation for glomerular filtration rate estimation and comparison with the Asian-modified CKD-EPI equation in Chinese chronic kidney disease patients in an external study |
| title_fullStr | Validation of the EKFC equation for glomerular filtration rate estimation and comparison with the Asian-modified CKD-EPI equation in Chinese chronic kidney disease patients in an external study |
| title_full_unstemmed | Validation of the EKFC equation for glomerular filtration rate estimation and comparison with the Asian-modified CKD-EPI equation in Chinese chronic kidney disease patients in an external study |
| title_short | Validation of the EKFC equation for glomerular filtration rate estimation and comparison with the Asian-modified CKD-EPI equation in Chinese chronic kidney disease patients in an external study |
| title_sort | validation of the ekfc equation for glomerular filtration rate estimation and comparison with the asian modified ckd epi equation in chinese chronic kidney disease patients in an external study |
| topic | Chronic kidney disease (CKD) glomerular filtration rate (GFR) EKFC equation Asian-modified CKD-EPI equation |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2150217 |
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