Impact and Interest of Implementing the EKFC Formula over CKD-EPI for Estimating Glomerular Filtration Rate in Automated Estimated Glomerular Filtration Rate Reporting Within Laboratory Practice - European Medical Journal

Impact and Interest of Implementing the EKFC Formula over CKD-EPI for Estimating Glomerular Filtration Rate in Automated Estimated Glomerular Filtration Rate Reporting Within Laboratory Practice

1 Mins
Nephrology
Authors:
*Laurence Derain Dubourg,1,2,3 Sandrine Lemoine,1,2,4 Pierre Letourneau,1 Lara Cabezas,1 Aurelie De Mul,1,2,5 Laurence Chardon6
  • 1. Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Centre de Référence des Maladies Rénales Rares MAREGE, filière maladies rares ORKID, Hôpital E. Herriot, Hospices Civils de Lyon, France
  • 2. Faculté de Médecine Lyon Est, Université de Lyon, France
  • 3. CNRS UMR 5305, University of Lyon 1, France
  • 4. INSERM CARMEN 1060 IRIS Team, Lyon, France
  • 5. INSERM1033, Lyon, France
  • 6. Service de Biochimie et Biologie Moléculaire, Laboratoire de Biologie Médicale Multi-Sites (LBMMS), Hospices Civils de Lyon, Bron, France
*Correspondence to [email protected]
Disclosure:

Derain has received support for attending meetings and/or travel from Boehringer Ingelheim in 2023 for the SFNDT Congress held in Liège, Belgium. The other authors have declared no conflicts of interest.

Citation:
EMJ Nephrol. ;12[1]:47-48. https://doi.org/10.33590/emjnephrol/NZFZ7713.
Keywords:
CKD-EPI equation, creatinine, European-Kidney-Function-Consortium (EKFC) equation, glomerular filtration rate (GFR), GFR estimating equation.

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

INTRODUCTION

The automatic reporting of estimated glomerular filtration rate (eGFR) for all creatinine (Pcr) determination is mandatory, and the CKD-EPI 2009 formula1 is considered the most accurate. However, CKD-EPI is inadequate in young adults and is debated in the elderly. The European-Kidney-Function-Consortium (EKFC) equation2 provides continuous eGFR from 2-year-olds to elderly. The authors’ objective was to assess the impact of using the EKFC compared to CKD-EPI.

METHODS

The authors retrieved data from the laboratory database, including gender, age, and Pcr for all patients over 18 years in November 2023. eGFR was calculated using the CKD-EPI and the EKFC. Results were expressed as the mean bias between EKFC and CKD-EPI (as reference) according to age groups.

RESULTS

A total of 10,066 patients (50.5% females; mean age 56.0±21.2 years [18.0–106.7]) underwent Pcr determination (mean 84.7±72.3 µmol/L) with 1,706 (16.9%) and 405 (4.0%) having a GFR <60 or <30 mL/min/1.73 m2, respectively. Bias EKFC-CKD-EPI was small (-3.3±3.1 mL/min/1.73 m2) in the 40–70 years group, whereas it was increased both in young adults and elderly (-16.4±5.1, -6.2±4.6, and -6.9±3.6 mL/min/1.73 m2 in the 18–25, 25–40, and >70 years groups, respectively). The proportion of misclassified patients with GFR <60 mL/min/1.73 m2 is small, except in the elderly (9.3%) when CKD-EPI is considered less accurate.

CONCLUSION

The use of EKFC in laboratories to estimate eGFR offers continuous GFR estimation from 2-year-olds to the elderly, and could be an alternative to CKD-EPI. The automatic reporting of eGFR with EKFC by laboratories could allow for an earlier diagnosis of CKD, and initiation of nephroprotection in young adults and the elderly.

References
Levey AS et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604-12. Pottel H et al. Development and validation of a modified full age spectrum creatinine-based equation to estimate glomerular filtration rate: a cross-sectional analysis of pooled data. Ann Intern Med. 2021;174:183‑91

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