Comparison of Plasma Clearance With Early-Compartment Correction Equations and Urinary Clearance in High GFR Ranges

Delanaye, Pierre; Vidal‐Petiot, Emmanuelle; Stehlé, Thomas; Dubourg, Laurence; Sterner, Gunnar; White, Christine; Lemoine, Sandrine; Audard, Vincent; Prié, Dominique; Courbebaisse, Marie; Pottel, Hans; Flamant, Martin

doi:10.1016/j.ekir.2021.03.886

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…First, an equation always performs better in the cohort in which it has been developed. Second, contrary to American cohorts with mGFR predominantly obtained via renal clearance of iothalamate, Europeans cohorts used a majority of plasma clearance techniques to measure GFR and enzymatic assays to measure serum creatinine (18,31,32). Third, sensu stricto, US cohorts are considering non-Black populations as a whole (including Native Americans, Mexican, Asian and Hispanic people) whereas, non-Black European populations included here are potentially more homogenous.…”

Section: Discussionmentioning

confidence: 99%

Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil and Africa

Delanaye

Vidal‐Petiot

Björk

et al. 2022

Nephrology Dialysis Transplantation

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Background A new Chronic Kidney Disease Epidemiology equation without race variable has been recently proposed (CKD-EPIAS). This equation has neither been validated outside USA nor compared to the new European Kidney Function Consortium (EKFC) and Lund-Malmö Revised (LMREV) equations, developed in European cohorts. Methods Standardized creatinine and measured glomerular filtration rate (GFR) from the European EKFC cohorts (n = 13 856 including 6031 individuals in the external validation cohort), from France, (n = 4429, including 964 Black Europeans), from Brazil (n = 100), and from Africa (n = 508) were used to test the performances of the equations. A matched analysis between White Europeans and Black Africans or Black Europeans was performed. Results In White Europeans (n = 9496), both the EKFC and LMREV equations outperformed CKD-EPIAS (bias of -0.6 and -3.2, respectively versus 5.0 mL/min/1.73m², and accuracy within 30% of 86.9 and 87.4, respectively versus 80.9%). In Black Europeans and Black Africans, the best performance was observed with the EKFC equation using a specific Q-value ( = concentration of serum creatinine in healthy males and females). These results were confirmed in matched analyses, which showed that serum creatinine concentrations were different in White Europeans, Black Europeans, and Black Africans for the same measured GFR, age, sex and body mass index. Creatinine differences were more relevant in males. Conclusion In a European and African cohort, the performances of CKD-EPIAS remain suboptimal. The EKFC equation, using usual or dedicated, population-specific Q-values presents the best performance in the whole age range in the European and African populations included in this study.

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Section: Discussionmentioning

confidence: 99%

Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil and Africa

Delanaye

Vidal‐Petiot

Björk

et al. 2022

Nephrology Dialysis Transplantation

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“…First, measured GFR in the CRIC and Minnesota cohort is obtained via the clearance of non-radiolabeled iothalamate assayed with capillary electrophoresis from timed plasma and urine samples, whereas mGFR in the EKFC cohort was obtained with iohexol, inulin or 51 Cr-EDTA, and mostly using plasma clearance. So there is a clear difference in GFR measurement methods between the CRIC, Minnesota and EKFC cohorts [7,8,11,33]. Second, there are differences in the preparation of patients prior to the measurement of GFR (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Different factors such as the reference method used to measure GFR (i.e. iohexol versus iothalamate and plasma versus urine clearance) can explain why such differences are observed [7][8][9][10][11]. However, in the example mentioned above, the opposite systematic dif-ference between the two cohorts clearly raises questions about another factor, i.e.…”

Section: Introductionmentioning

confidence: 98%

Standardization of serum creatinine is essential for accurate use of unbiased estimated GFR equations: evidence from three cohorts matched on renal function

Pottel

Cavalier

Björk

et al. 2022

Clinical Kidney Journal

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Background Differences in performance of estimating glomerular filtration rate (eGFR) equations have been attributed to the mathematical form of the equations and to differences between patient demographics and measurement methods. We evaluated differences in serum creatinine (SCr) and eGFR in cohorts matching for age, sex, BMI and measured GFR (mGFR). Methods White North Americans from Minnesota (n = 1093) and the Chronic Renal Insufficiency Cohort (CRIC) (n = 1548), and White subjects from the European Kidney Function Consortium (EKFC) cohort (n = 7727), were matched for demographic patient characteristics (equal sex, age ± 3 years, BMI ± 2.5 kg/m²) and renal function (measured GFR ± 3 mL/min/1.73m²). SCr was measured with isotope dilution mass spectrometry (IDMS) traceable assays in Minnesota and EKFC and with non-standardized SCr-assays recalculated to IDMS in CRIC. Minnesota and CRIC shared the common method to measure GFR (renal clearance of iothalamate) while EKFC used a variety of exogenous markers and methods, all with recognized sufficient accuracy. We compared the SCr-levels and eGFR-predictions (for CKD-EPI and EKFC-equations) of patients fulfilling these matching criteria. Results For 305 matched individuals, mean SCr was not different between Minnesota and EKFC 0.83 ± 0.20 vs 0.86 ± 0.23, females and 1.06 ± 0.23 vs 1.12 ± 0.37, males (P > 0.05), but significantly different from CRIC (1.13 ± 0.23 (P < 0.0001), females and 1.42 ± 0.31 (P < 0.0001), males). CKD-EPI-equations performed better than the EKFC-equation in the CRIC-cohort, while the opposite was true in the Minnesota and EKFC-cohort. Conclusion Significant differences in SCr-concentrations between Minnesota/EKFC versus CRIC were observed in subjects with the same level of mGFR and equal demographic characteristics and can be explained by the difference in SCr-calibration.

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“…One goal of the European Kidney Function Consortium (EKFC) is to increase the standardization of GFR measurements. Recently, members of the EKFC have compared plasma versus urinary clearances 6,7 , single versus multiple-sample plasma clearances 5,8 , and the different equations used in multiple-sample methods to model the first (or early) compartment 9 . The plasma clearance is calculated by dividing the amount of iohexol injected by the area under the curve obtained from concentrations at single-or multiple times (equations are given in Supplementary Table S1).…”

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confidence: 99%

Iohexol Plasma Clearance: Impact of Weighing the Syringe

Delanaye

Melsom

Cavalier

et al. 2021

Kidney International Reports

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Comparison of Plasma Clearance With Early-Compartment Correction Equations and Urinary Clearance in High GFR Ranges

Cited by 8 publications

References 29 publications

Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil and Africa

Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil and Africa

Standardization of serum creatinine is essential for accurate use of unbiased estimated GFR equations: evidence from three cohorts matched on renal function

Iohexol Plasma Clearance: Impact of Weighing the Syringe

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