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New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race.

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Τίτλος: New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race.
Συγγραφείς: Inker, L.A., Eneanya, N.D., Coresh, J., Tighiouart, H., Wang, D., Sang, Y., Crews, D.C., Doria, A., Estrella, M.M., Froissart, M., Grams, M.E., Greene, T., Grubb, A., Gudnason, V., Gutiérrez, O.M., Kalil, R., Karger, A.B., Mauer, M., Navis, G., Nelson, R.G., Poggio, E.D., Rodby, R., Rossing, P., Rule, A.D., Selvin, E., Seegmiller, J.C., Shlipak, M.G., Torres, V.E., Yang, W., Ballew, S.H., Couture, S.J., Powe, N.R., Levey, A.S.
Συνεισφορές: Chronic Kidney Disease Epidemiology Collaboration, Andresdottir, M.B., Gudmundsdottir, H., Indridason, O.S., Palsson, R., Kasiske, B., Weir, M., Pesavento, T., Kalil, R., Feldman, H., Anderson, A., Go, A., Hsu, C.Y., Chapman, A.B., Landsittel, D.P., Mrug, M., Yu, ASL, Steffes, M., Braffett, B.H., Wyatt, C., Krishnasami, Z., Hellinger, J., Abraham, A., Lieske, J.C., Shafi, T., Post, W., Rossing, P., Rossert, J., Stengel, B., Galecki, A., Spino, C., Mauer, M., Karger, A., Zinman, B., Klein, R., Parving, H.H., Looker, H.C., Knowler, W.C., Klintmalm, G.B., Velez, R., Selvin, E., Wang, D.
Έτος έκδοσης: 2021
Συλλογή: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Θεματικοί όροι: Adult, African Continental Ancestry Group, Aged, Algorithms, Continental Population Groups, Creatinine/blood, Cystatin C/blood, Datasets as Topic, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Renal Insufficiency, Chronic/blood, Chronic/epidemiology, Chronic/ethnology, Chronic/physiopathology, United States/epidemiology
Περιγραφή: Current equations for estimated glomerular filtration rate (eGFR) that use serum creatinine or cystatin C incorporate age, sex, and race to estimate measured GFR. However, race in eGFR equations is a social and not a biologic construct. We developed new eGFR equations without race using data from two development data sets: 10 studies (8254 participants, 31.5% Black) for serum creatinine and 13 studies (5352 participants, 39.7% Black) for both serum creatinine and cystatin C. In a validation data set of 12 studies (4050 participants, 14.3% Black), we compared the accuracy of new eGFR equations to measured GFR. We projected the prevalence of chronic kidney disease (CKD) and GFR stages in a sample of U.S. adults, using current and new equations. In the validation data set, the current creatinine equation that uses age, sex, and race overestimated measured GFR in Blacks (median, 3.7 ml per minute per 1.73 m 2 of body-surface area; 95% confidence interval [CI], 1.8 to 5.4) and to a lesser degree in non-Blacks (median, 0.5 ml per minute per 1.73 m 2 ; 95% CI, 0.0 to 0.9). When the adjustment for Black race was omitted from the current eGFR equation, measured GFR in Blacks was underestimated (median, 7.1 ml per minute per 1.73 m 2 ; 95% CI, 5.9 to 8.8). A new equation using age and sex and omitting race underestimated measured GFR in Blacks (median, 3.6 ml per minute per 1.73 m 2 ; 95% CI, 1.8 to 5.5) and overestimated measured GFR in non-Blacks (median, 3.9 ml per minute per 1.73 m 2 ; 95% CI, 3.4 to 4.4). For all equations, 85% or more of the eGFRs for Blacks and non-Blacks were within 30% of measured GFR. New creatinine-cystatin C equations without race were more accurate than new creatinine equations, with smaller differences between race groups. As compared with the current creatinine equation, the new creatinine equations, but not the new creatinine-cystatin C equations, increased population estimates of CKD prevalence among Blacks and yielded similar or lower prevalence among non-Blacks. New eGFR equations that ...
Τύπος εγγράφου: article in journal/newspaper
Περιγραφή αρχείου: application/pdf
Γλώσσα: English
ISSN: 1533-4406
Relation: New England Journal of Medicine; https://iris.unil.ch/handle/iris/179472; serval:BIB_D550EFCE6824; 000698478800001
DOI: 10.1056/NEJMoa2102953
Διαθεσιμότητα: https://iris.unil.ch/handle/iris/179472
https://doi.org/10.1056/NEJMoa2102953
Αριθμός Καταχώρησης: edsbas.6A482AFD
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  Data: New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race.
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  Data: Chronic Kidney Disease Epidemiology Collaboration<br />Andresdottir, M.B.<br />Gudmundsdottir, H.<br />Indridason, O.S.<br />Palsson, R.<br />Kasiske, B.<br />Weir, M.<br />Pesavento, T.<br />Kalil, R.<br />Feldman, H.<br />Anderson, A.<br />Go, A.<br />Hsu, C.Y.<br />Chapman, A.B.<br />Landsittel, D.P.<br />Mrug, M.<br />Yu, ASL<br />Steffes, M.<br />Braffett, B.H.<br />Wyatt, C.<br />Krishnasami, Z.<br />Hellinger, J.<br />Abraham, A.<br />Lieske, J.C.<br />Shafi, T.<br />Post, W.<br />Rossing, P.<br />Rossert, J.<br />Stengel, B.<br />Galecki, A.<br />Spino, C.<br />Mauer, M.<br />Karger, A.<br />Zinman, B.<br />Klein, R.<br />Parving, H.H.<br />Looker, H.C.<br />Knowler, W.C.<br />Klintmalm, G.B.<br />Velez, R.<br />Selvin, E.<br />Wang, D.
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  Data: Current equations for estimated glomerular filtration rate (eGFR) that use serum creatinine or cystatin C incorporate age, sex, and race to estimate measured GFR. However, race in eGFR equations is a social and not a biologic construct. We developed new eGFR equations without race using data from two development data sets: 10 studies (8254 participants, 31.5% Black) for serum creatinine and 13 studies (5352 participants, 39.7% Black) for both serum creatinine and cystatin C. In a validation data set of 12 studies (4050 participants, 14.3% Black), we compared the accuracy of new eGFR equations to measured GFR. We projected the prevalence of chronic kidney disease (CKD) and GFR stages in a sample of U.S. adults, using current and new equations. In the validation data set, the current creatinine equation that uses age, sex, and race overestimated measured GFR in Blacks (median, 3.7 ml per minute per 1.73 m 2 of body-surface area; 95% confidence interval [CI], 1.8 to 5.4) and to a lesser degree in non-Blacks (median, 0.5 ml per minute per 1.73 m 2 ; 95% CI, 0.0 to 0.9). When the adjustment for Black race was omitted from the current eGFR equation, measured GFR in Blacks was underestimated (median, 7.1 ml per minute per 1.73 m 2 ; 95% CI, 5.9 to 8.8). A new equation using age and sex and omitting race underestimated measured GFR in Blacks (median, 3.6 ml per minute per 1.73 m 2 ; 95% CI, 1.8 to 5.5) and overestimated measured GFR in non-Blacks (median, 3.9 ml per minute per 1.73 m 2 ; 95% CI, 3.4 to 4.4). For all equations, 85% or more of the eGFRs for Blacks and non-Blacks were within 30% of measured GFR. New creatinine-cystatin C equations without race were more accurate than new creatinine equations, with smaller differences between race groups. As compared with the current creatinine equation, the new creatinine equations, but not the new creatinine-cystatin C equations, increased population estimates of CKD prevalence among Blacks and yielded similar or lower prevalence among non-Blacks. New eGFR equations that ...
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  Data: New England Journal of Medicine; https://iris.unil.ch/handle/iris/179472; serval:BIB_D550EFCE6824; 000698478800001
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      – PersonEntity:
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            NameFull: Wyatt, C.
      – PersonEntity:
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            NameFull: Krishnasami, Z.
      – PersonEntity:
          Name:
            NameFull: Hellinger, J.
      – PersonEntity:
          Name:
            NameFull: Abraham, A.
      – PersonEntity:
          Name:
            NameFull: Lieske, J.C.
      – PersonEntity:
          Name:
            NameFull: Shafi, T.
      – PersonEntity:
          Name:
            NameFull: Post, W.
      – PersonEntity:
          Name:
            NameFull: Rossing, P.
      – PersonEntity:
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            NameFull: Rossert, J.
      – PersonEntity:
          Name:
            NameFull: Stengel, B.
      – PersonEntity:
          Name:
            NameFull: Galecki, A.
      – PersonEntity:
          Name:
            NameFull: Spino, C.
      – PersonEntity:
          Name:
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      – PersonEntity:
          Name:
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      – PersonEntity:
          Name:
            NameFull: Zinman, B.
      – PersonEntity:
          Name:
            NameFull: Klein, R.
      – PersonEntity:
          Name:
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      – PersonEntity:
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      – PersonEntity:
          Name:
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      – PersonEntity:
          Name:
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      – PersonEntity:
          Name:
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          Name:
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      – PersonEntity:
          Name:
            NameFull: Wang, D.
    IsPartOfRelationships:
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            – D: 01
              M: 01
              Type: published
              Y: 2021
          Identifiers:
            – Type: issn-print
              Value: 15334406
            – Type: issn-locals
              Value: edsbas
ResultId 1