New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race
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Résumé
BACKGROUND: 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. METHODS: 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. RESULTS: ; 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. CONCLUSIONS: New eGFR equations that incorporate creatinine and cystatin C but omit race are more accurate and led to smaller differences between Black participants and non-Black participants than new equations without race with either creatinine or cystatin C alone. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases.).
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La notice
- Revue
- New England Journal of Medicine
- Thématique
- Chronic Kidney Disease and Diabetes
- Domaine
- Medicine
- Établissements canadiens
- —
- Organismes subventionnaires
- National Institute on Minority Health and Health DisparitiesNational Center for Research ResourcesNational Heart, Lung, and Blood InstituteNational Eye InstituteNational Institute on AgingCanadian Institutes of Health ResearchU.S. Public Health ServiceNational Institutes of HealthGilead SciencesJuvenile Diabetes Research Foundation United States of AmericaNational Center for Advancing Translational SciencesNational Center for Health StatisticsSteno Diabetes Center CopenhagenRocheTufts Medical CenterMinistère des Solidarités et de la SantéKaiser PermanenteUniversity of MinnesotaMerckNational Institute of Diabetes and Digestive and Kidney DiseasesLunds UniversitetBristol-Myers Squibb
- Mots-clés
- CreatinineCystatin CRace (biology)Renal functionCystatin
- Résumé présent dans OpenAlex
- oui