Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 28;62(3):421-427.
doi: 10.1515/cclm-2023-0496. Print 2024 Feb 26.

Rescaling creatinine makes GFR estimation equations generally applicable across populations - validation results for the Lund-Malmö equation in a French cohort of sub-Saharan ancestry

Ulf Nyman  1 , Jonas Björk  2   3 , Pierre Delanaye  4   5 , Alexandre Lahens  6 , Hans Pottel  7 , Emmanuelle Vidal-Petiot  6   8 , Martin Flamant  6   9
Affiliations
Free article

Rescaling creatinine makes GFR estimation equations generally applicable across populations - validation results for the Lund-Malmö equation in a French cohort of sub-Saharan ancestry

Ulf Nyman et al. Clin Chem Lab Med. .
Free article

Abstract

Objectives: To make glomerular filtration rate (GFR) estimating equations applicable across populations with different creatinine generation by using rescaled serum creatinine (sCr/Q) where sCr represents the individual creatinine level and Q the average creatinine value in healthy persons of the same population.

Methods: GFR measurements (mGFR, plasma clearance of 51Cr-EDTA) were conducted in 964 adult Black Europeans. We established the re-expressed Lund-Malmö revised equation (r-LMR) by replacing serum creatinine (sCr) with rescaled creatinine sCr/Q. We evaluated the r-LMR equation based on Q-values of White Europeans (r-LMRQ-white; Q-values females: 62 μmol/L, males: 80 μmol/L) and Black Europeans (r-LMRQ-Black; Q-values females: 65 μmol/L, males: 90 μmol/L), and the European Kidney Function Consortium equation (EKFCQ-White and EKFCQ-Black) regarding bias, precision (interquartile range, IQR) and accuracy (percentage of estimates within ±10 % [P10] and ±30 % [P30] of mGFR).

Results: Median bias of r-LMRQ-White/r-LMRQ-Black/EKFCQ-White/EKFCQ-Black were -9.1/-4.5/-6.3/-0.9 mL/min/1.73 m2, IQR 14.7/14.5/14.5/15.6 mL/min/1.73 m2, P10 25.1 %/34.8 %/30.3 %/37.2 % and P30 74.2 %/84.1 %/80.6 %/83.6 %. The improvement of bias and accuracy when using proper Q-values was most pronounced in men. Similar improvements were obtained above and below mGFR 60 mL/min/1.73 m2 and at various age and BMI intervals, except for BMI<20 kg/m2 where bias increased, and accuracy decreased.

Conclusions: GFR estimating equations may be re-expressed to include rescaled creatinine (sCr/Q) and used across populations with different creatinine generation if population-specific average creatinine concentrations (Q-values) for healthy persons are established.

Keywords: chronic kidney disease; creatinine; glomerular filtration rate; kidney function tests.

PubMed Disclaimer

References

    1. Hsu, CY, Yang, W, Parikh, RV, Anderson, AH, Chen, TK, Cohen, DL, et al.. Race, genetic ancestry, and estimating kidney function in CKD. N Engl J Med 2021;385:1750–60. https://doi.org/10.1056/nejmoa2103753 . - DOI
    1. Levey, AS, Coresh, J, Tighiouart, H, Greene, T, Inker, LA. Measured and estimated glomerular filtration rate: current status and future directions. Nat Rev Nephrol 2019;16:51–64. https://doi.org/10.1038/s41581-019-0191-y . - DOI
    1. Delanaye, P, Ebert, N, Melsom, T, Gaspari, F, Mariat, C, Cavalier, E, et al.. Iohexol plasma clearance for measuring glomerular filtration rate in clinical practice and research: a review. Part 1: how to measure glomerular filtration rate with iohexol? Clin Kidney J 2016;9:682–99. https://doi.org/10.1093/ckj/sfw070 . - DOI
    1. Björk, J, Bäck, SE, Nordin, G, Nyman, U. How valid are GFR estimation results from the CKD-EPI databases? Am J Kidney Dis 2018;71:446. https://doi.org/10.1053/j.ajkd.2017.11.003 . - DOI
    1. Pottel, H, Hoste, L, Dubourg, L, Ebert, N, Schaeffner, E, Eriksen, BO, et al.. An estimated glomerular filtration rate equation for the full age spectrum. Nephrol Dial Transplant 2016;31:798–806. https://doi.org/10.1093/ndt/gfv454 . - DOI

Publication types

LinkOut - more resources