An estimated glomerular filtration rate equation for the full age spectrum

Pottel, Hans; Hoste, Liesbeth; Dubourg, Laurence; Ebert, Natalie; Schaeffner, Elke; Eriksen, Bjørn Odvar; Melsom, Toralf; Lamb, Edmund J.; Rule, Andrew D.; Turner, Stephen T.; Glassock, Richard J.; Souza, V. de; Selistre, Luciano; Mariat, Christophe; Martens, Frank; Delanaye, Pierre

doi:10.1093/ndt/gfv454

Cited by 391 publications

(343 citation statements)

References 47 publications

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“…This meta-analysis also underlines the necessity of future research in other ethnicities, in healthy subjects >65 years and in a longitudinal design. The results of the current meta-analysis also support the mathematical construction of the new FAS equation recently proposed to estimate GFR with a good precision and accuracy from infancy to older age [21] .…”

Section: Discussionsupporting

confidence: 76%

“…Only after 40 years, the mGFR observed is significantly lower than in these youngest. This observation also justifies the mathematical construction of the FAS equation, which models the decline in GFR from 40 years on [21] . /year (for men).…”

Section: Discussionsupporting

confidence: 68%

“…Indeed, the FAS equation and CKD-EPI equation clearly differ in mathematical construction. The FAS equation implies that (i) mean GFR of healthy subjects aged between 18 and 40 years is approximately 107 ml/ min/1.73 m 2 and not decreasing from around 125 (at 18 years) to 107 ml/min/1.73 m 2 (at 40 years), as predicted by CKD-EPI, (ii) GFR is not different in men and women, thus, no gender multiplication factor at the GFR level is required and (iii) decline in GFR only begins at 40 years and not already at the age of 18 years, as built in the mathematical construction of the CKD-EPI equation [21] . Moreover, this decline rate is faster in FAS (as expressed by 0.988 age ) than in the CKD-EPI equation (as expressed by 0.993 age ).…”

Section: Introductionmentioning

confidence: 97%

“…When does the physiological decrease in GFR begin? All these questions are also of importance to evaluate and compare the construction of the recommended Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation [4] and the new full age spectrum (FAS) equation [21] , which was recently proposed to estimate GFR across the entire age spectrum from 2 to old age (FASeGFR = 107.3/(Scr/Q) × 0.988 (age-40) when age >40 years), where Q is the median Scr concentration for healthy agematched subjects (0.90 mg/dl for men and 0.70 mg/dl for women). Indeed, the FAS equation and CKD-EPI equation clearly differ in mathematical construction.…”

Section: Introductionmentioning

confidence: 99%

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Glomerular Filtration Rate in Healthy Living Potential Kidney Donors: A Meta-Analysis Supporting the Construction of the Full Age Spectrum Equation

Pottel

Hoste

Yayo

et al. 2016

Nephron

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Background: Normal kidney function or, more specifically, normal glomerular filtration rate (GFR) in men and women and its decline with age is still much debated today. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has gender (and race) multiplication factors, accounts for a decline that starts at very young age and assumes that the mean GFR is as high as 120-130 ml/min/1.73 m² from a young age. The full age spectrum (FAS) estimated mean GFR is about 107 ml/min/1.73 m² at a young age and remains constant until the age of 40 years and then starts to decline both in men and women. The aim of this research study was to give more insight into ‘normal' GFR levels and the physiological decrease of kidney function with age and to use a meta-analysis to evaluate the mathematical construction of the FAS and the CKD-EPI equation. Methods: We conducted a meta-analysis of published GFR measurements in healthy Caucasian living potential kidney donors (n = 5,482, 46.8% men). Only publications dating from 2000 were selected to avoid the possible influence of body surface area changes in the last decades on the indexed GFR, expressed in ml/min/1.73 m². Results: We found that the mean GFR ≈ 107 ml/min/1.73 m² up to the age of 40 years, but renal decline begins beyond 40 years. No evidence could be found for any difference between men and women in the separate age groups. Conclusions: The current meta-analysis supports the mathematical form of the FAS equation, which matches the age/sex dependency of measured GFR for healthy potential living kidney donors.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Glomerular Filtration Rate in Healthy Living Potential Kidney Donors: A Meta-Analysis Supporting the Construction of the Full Age Spectrum Equation

Pottel

Hoste

Yayo

et al. 2016

Nephron

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“…6 The FAS creatinine and cystatin C equations were developed from assumptions about distributions of normal values for serum creatinine, cystatin C, and GFR and were validated in study populations of whites in North America and Europe. 7,8 In this report, we compare the performance of the LMR, CAPA, and FAS equations with the CKD-EPI equations in studies included in the CKD-EPI validation database. Because these studies were not used for the development of the CKD-EPI equations, they provide an unbiased study population for this comparison.…”

Section: Research Letters Comparing Newer Gfr Estimating Equations Usmentioning

confidence: 99%

Comparing Newer GFR Estimating Equations Using Creatinine and Cystatin C to the CKD-EPI Equations in Adults

Levey

Tighiouart

Simon

et al. 2017

American Journal of Kidney Diseases

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Diagnostic Performance of Creatinine-Based Equations for Estimating Glomerular Filtration Rate in Adults 65 Years and Older

et al. 2019

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IMPORTANCE Estimating glomerular filtration rate (GFR) is useful in many clinical conditions. However, very few studies have evaluated the performance of GFR-estimating equations in older adults at various degrees of kidney impairment. OBJECTIVE To determine the performance of plasma-creatinine-based equations Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI), Lund-Malmö Revised, (LMR), full age spectrum (FAS), and Berlin Initiative Study (BIS) 1 in older adults across a broad spectrum of GFRs. DESIGN, SETTING, AND PARTICIPANTS Single-center cross-sectional study performed in France including 2247 participants aged 65 to 90 years who underwent inulin GFR measurements from July 1, 2003, to July 30, 2017, for suspected or established renal dysfunction, for renal risk, before kidney donation, or after kidney transplant. MAIN OUTCOMES AND MEASURES The main outcome measure was GRF measured by inulin clearance. Equation performance criteria considered bias (difference between estimated and measured GFR), precision (interquartile range of the median difference), and accuracy P 30 (percentage of estimated GFRs lying between [measured GFR-30% of measured GFR] and [measured GFR + 30% of measured GFR]). RESULTS The mean (SD) age of the 2247 participants was 71.5 (5) years and 1192 (53.0%) were male. The difference in median (95% CI) bias was significant between CKD-EPI vs LMR (−4.0 [-4.0 to-3.5 mL/min/1.73 m 2 ; P < .001]) and CKD-EPI vs FAS (-2.0 [-3.5 to-2.5] mL/min/1.73 m 2 , P < .001) but not significant between CKD-EPI vs BIS 1 (0.0 [-1.5 to 0.5], P = .07, Mood test). In patients aged 65 to 74 years with measured GFR<45 mL/min/1.73 m 2 , the difference in median P 30 (95% CI) was not significant between CKD-EPI vs LMR (P = .08) and CKD-EPI vs FAS (P = .48) but significant vs BIS 1 (P = .004, McNemar test). In subjects 75 years and older, with measured GFR less than 45 mL/min/1.73 m 2 , LMR and BIS 1 were more accurate than CKD-EPI and FAS (P 30 = 74.

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An estimated glomerular filtration rate equation for the full age spectrum

Abstract: The FAS equation has improved validity and continuity across the full age-spectrum and overcomes the problem of implausible eGFR changes in patients which would otherwise occur when switching between more age-specific equations.

Cited by 391 publications

References 47 publications

Glomerular Filtration Rate in Healthy Living Potential Kidney Donors: A Meta-Analysis Supporting the Construction of the Full Age Spectrum Equation

Glomerular Filtration Rate in Healthy Living Potential Kidney Donors: A Meta-Analysis Supporting the Construction of the Full Age Spectrum Equation

Comparing Newer GFR Estimating Equations Using Creatinine and Cystatin C to the CKD-EPI Equations in Adults

Diagnostic Performance of Creatinine-Based Equations for Estimating Glomerular Filtration Rate in Adults 65 Years and Older

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