Comparison of equations for estimating glomerular filtration rate in screening for chronic kidney disease in asymptomatic black Africans: a cross sectional study

BMC Nephrology

Research Article

Angela Amayo¹  Alice Kanyua²  Geoffrey Omuse³  Elizabeth Kagotho³  Daniel Maina³  Peter Ojwang⁴  Rajiv Erasmus⁵  Jane Mwangi⁶  Caroline Wambua⁶ 

[1] Department of Human Pathology, University of Nairobi, P.O. Box 19676-00200, Nairobi, Kenya;Department of Pathology, Aga Khan Hospital, P.O. Box 2289, Dar es Salaam, Tanzania;Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya;Department of Pathology, Maseno University, P.O. Box Private Bag, Maseno, Kenya;Division of Chemical Pathology, Department of Pathology, Stellenbosch University, P.O. Box 19113, Tygerberg Hospital, Cape Town, South Africa;PathCare Kenya Ltd., P.O. Box 12560-00606, Nairobi, Kenya;

关键词: MDRD;    CKD-EPI;    Cockcroft-Gault;    FAS;    eGFR;   

DOI  :  10.1186/s12882-017-0788-y

 received in 2016-05-26, accepted in 2017-12-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSeveral equations have been developed to estimate glomerular filtration rate (eGFR). The common equations used were derived from populations predominantly comprised of Caucasians with chronic kidney disease (CKD). Some of the equations provide a correction factor for African-Americans due to their relatively increased muscle mass and this has been extrapolated to black Africans. Studies carried out in Africa in patients with CKD suggest that using this correction factor for the black African race may not be appropriate. However, these studies were not carried out in healthy individuals and as such the extrapolation of the findings to an asymptomatic black African population is questionable. We sought to compare the proportion of asymptomatic black Africans reported as having reduced eGFR using various eGFR equations. We further compared the association between known risk factors for CKD with eGFR determined using the different equations.MethodsWe used participant and laboratory data collected as part of a global reference interval study conducted by the Committee of Reference Intervals and Decision Limits (C-RIDL) under the International Federation of Clinical Chemistry (IFCC). Serum creatinine values were used to calculate eGFR using the Cockcroft-Gault (CG), re-expressed 4 variable modified diet in renal disease (4v–MDRD), full age spectrum (FAS) and chronic kidney disease epidemiology collaboration equations (CKD-EPI). CKD classification based on eGFR was determined for every participant.ResultsA total of 533 participants were included comprising 273 (51.2%) females. The 4v–MDRD equation without correction for race classified the least number of participants (61.7%) as having an eGFR equivalent to CKD stage G1 compared to 93.6% for CKD-EPI with correction for race. Only age had a statistically significant linear association with eGFR across all equations after performing multiple regression analysis. The multiple correlation coefficients for CKD risk factors were higher for CKD-EPI determined eGFRs.ConclusionsThis study found that eGFR determined using CKD-EPI equations better correlated with a prediction model that included risk factors for CKD and classified fewer asymptomatic black Africans as having a reduced eGFR compared to 4v–MDRD, FAS and CG corrected for body surface area.

【 授权许可】

CC BY   
© The Author(s). 2017