Abstract

ABSTRACT

Background

Differences in the performance of estimated glomerular filtration rate (eGFR) equations have been attributed to the mathematical form of the equations and to differences between patient demographics and measurement methods. We evaluated differences in serum creatinine (SCr) and eGFR in cohorts matched for age, sex, body mass index (BMI) and measured GFR (mGFR).

Methods

White North Americans from Minnesota (n = 1093) and the Chronic Renal Insufficiency Cohort (CRIC) (n = 1548) and White subjects from the European Kidney Function Consortium (EKFC) cohort (n = 7727) were matched for demographic patient characteristics (sex, age ± 3 years, BMI ± 2.5 kg/m2) and renal function (mGFR ± 3 ml/min/1.73 m2). SCr was measured with isotope dilution mass spectrometry (IDMS)-traceable assays in the Minnesota and EKFC cohorts and with non-standardized SCr assays recalculated to IDMS in the CRIC. The Minnesota cohort and CRIC shared a common method to measure GFR (renal clearance of iothalamate), while the EKFC cohort used a variety of exogenous markers and methods, all with recognized sufficient accuracy. We compared the SCr levels and eGFR predictions [for Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and EKFC equations] of patients fulfilling these matching criteria.

Results

For 305 matched individuals, mean SCr (mg/dL) was not different between the Minnesota and EKFC cohorts (females 0.83 ± 0.20 versus 0.86 ± 0.23, males 1.06 ± 0.23 versus 1.12 ± 0.37; P > .05) but significantly different from the CRIC [females 1.13 ± 0.23 (P < .0001), males 1.42 ± 0.31 (P < .0001)]. The CKD-EPI equations performed better than the EKFC equation in the CRIC, while the opposite was true in the Minnesota and EKFC cohorts.

Conclusion

Significant differences in SCr concentrations between the Minnesota and EKFC cohorts versus CRIC were observed in subjects with the same level of mGFR and equal demographic characteristics and can be explained by the difference in SCr calibration.

Details

Title
Standardization of serum creatinine is essential for accurate use of unbiased estimated GFR equations: evidence from three cohorts matched on renal function
Author
Pottel, Hans 1   VIAFID ORCID Logo  ; Cavalier, Etienne 2 ; Björk, Jonas 3   VIAFID ORCID Logo  ; Nyman, Ulf 4 ; Grubb, Anders 5 ; Ebert, Natalie 6   VIAFID ORCID Logo  ; Schaeffner, Elke 6 ; Eriksen, Björn O 7 ; Melsom, Toralf 7 ; Lamb, Edmund J 8 ; Mariat, Christophe 9 ; Dubourg, Laurence 10 ; Hansson, Magnus 11 ; Littmann, Karin 12 ; Sundin, Per-Ola 13   VIAFID ORCID Logo  ; Åkesson, Anna 3 ; Larsson, Anders 14 ; Rule, Andrew 15 ; Delanaye, Pierre 16   VIAFID ORCID Logo 

1  Department of Public Health and Primary Care , KU Leuven Campus Kulak Kortrijk, Kortrijk , Belgium 
2  Department of Clinical Chemistry, University of Liège , CHU Sart Tilman, Liège , Belgium 
3  Division of Occupational and Environmental Medicine, Lund University , Lund , Sweden 
4  Department of Translational Medicine, Division of Medical Radiology, Lund University , Malmö , Sweden 
5  Department of Clinical Chemistry, Skåne University Hospital , Lund , Lund University , Sweden 
6  Charité Universitätsmedizin Berlin, Institute of Public Health , Berlin , Germany 
7  Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, UiT The Arctic University of Norway , Tromsö , Norway 
8  Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust , Canterbury , UK 
9  Service de Néphrologie, Dialyse et Transplantation Rénale , Hôpital Nord, CHU de Saint-Etienne, France 
10  Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale , Hôpital Edouard Herriot, Hospices Civils de Lyon, France 
11  Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute , Stockholm , Sweden 
12  Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institute , Huddinge, Sweden 
13  Department of Geriatrics, School of Medical Sciences, Örebro University , Örebro, Sweden 
14  Department of Medical Sciences, Clinical Chemistry, Uppsala University , Uppsala , Sweden 
15  Division of Nephrology and Hypertension, Mayo Clinic , Rochester, MN , USA 
16  Nephrology-Dialysis-Transplantation, University of Liège , CHU Sart Tilman, Liège, Belgium 
Pages
2258-2265
Publication year
2022
Publication date
Dec 2022
Publisher
Oxford University Press
ISSN
20488505
e-ISSN
20488513
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/ckj/sfac182
ProQuest document ID
3167996512
Copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.