Performance of Serum β2-Microglobulin– and β-Trace Protein–Based Panel Markers and 2021 Creatinine- and Cystatin-Based GFR Estimating Equations in Pakistan

Wang, Yeli; Levey, Andrew S.; Inker, Lesley A.; Jessani, Saleem; Bux, Rasool; Samad, Zainab; Yaqub, Sonia; Karger, Amy B.; Allen, John C.; Jafar, Tazeen H.

doi:10.1016/j.xkme.2022.100444

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…Since the CKD-EPI 2021 without race information has been introduced, studies have been conducted for validation of its performance in different ethnic populations and various clinical settings, such as older acute medical patients, patients who underwent lung transplantation or kidney transplantation, and patients with solid tumors [8,[11][12][13][14][15][16]. Previous studies reported the accuracy of CKD-EPI 2021 in different clinical settings [8,[11][12][13][14][15][16]. However, there is a lack of studies regarding the effect of the equation changes in a Korean adult population.…”

Section: Discussionmentioning

confidence: 99%

Alterations in Glomerular Filtration Rates Using Different Algorithms in the Korean Population Visiting Local Clinics and Hospitals

Choi

Lee

2022

JCM

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We retrospectively reviewed the estimated glomerular filtration rates (eGFR) calculated by three equations: (1) Modification of Diet in Renal Disease Study (MDRD), (2) Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) using serum creatinine in 2009 (CKD-EPI 2009), and (3) CKD-EPI suggested in 2021 (CKD-EPI 2021), in an adult Korean population visiting local clinics and hospitals for health check-ups between 2019 and 2021 to investigate the effect of changes in the prevalence of chronic kidney diseases using those equations. During the study period, serum creatinine tests were performed on 442,566 subjects (205,236 men and 237,330 women). The overall prevalence rates of decreased eGFR (<60 mL/min/1.73 m2) at baseline measurement were as follows: 3.4% using MDRD, 2.8% using CKD-EPI 2009, and 2.1% using CKD-EPI 2021. The prevalence of decreased eGFR increased with age. Among 442,566 tests, specimens having simultaneously measured random urine dipstick tests for proteinuria represented 6.0% of the population, and the albumin-creatinine ratio (ACR) was 0.3%. The prevalence of specimens having both decreased eGFR and proteinuria was significantly different among equations (p < 0.05). Among the three equations, MDRD and CKD-EPI 2009 had a similar specimen prevalence of decreased eGFR and proteinuria (≥1+) using a dipstick test or albuminuria (urine ACR > 30 mg/g creatinine), while those based on CKD-EPI 2021 were about half of those based on MDRD and CKD-EPI 2009. Future studies are needed to clarify the clinical impact of the changes in the calculations for eGFR.

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Section: Discussionmentioning

confidence: 99%

Alterations in Glomerular Filtration Rates Using Different Algorithms in the Korean Population Visiting Local Clinics and Hospitals

Choi

Lee

2022

JCM

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“…The current study is the foremost validation study assessing the EKFC equation with reference to measured GFR in the South Asian population. However, 2021 CKD-EPI and Pakistani CKD-EPI have been validated once in a previous study in this population [ 19 ] . These equations were assessed and compared in a CKD cohort in the South Asian region according to the recommendations made by KDIGO, and their expected implications were also determined in terms of GFR classification and prevalence of ESRD.…”

Section: Discussionmentioning

confidence: 99%

“…This formula has also been used for estimating the changes regarding comorbidities, demographics, and outcomes of CKD [ 21 ]. However, limited studies compared it with equations derived for other regions [ 19 , 22 ]. Moreover, no study has assessed EKFC compared to CKD-EPI PK in South Asia, with only one study evaluating 2021 CKD-EPI compared to the Pakistani CKD-EPI [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, limited studies compared it with equations derived for other regions [ 19 , 22 ]. Moreover, no study has assessed EKFC compared to CKD-EPI PK in South Asia, with only one study evaluating 2021 CKD-EPI compared to the Pakistani CKD-EPI [ 19 ]. In this report, we aimed to perform a performance evaluation for 2021 CKD-EPI , Pakistani CKD-EPI, and EKFC equation in South Asian individuals with CKD.…”

Section: Introductionmentioning

confidence: 99%

“…In 2021, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) recommended novel race-free equations (2021 Race-Free CKD-EPI Cr and CKD-EPI Cr-CysC ). These formulas were also derived and validated among European and US cohorts [15][16][17][18] and comprised very few Asians [15]: One study has evaluated these equations in the South Asia [19].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of EKFC, Pakistani CKD-EPI and 2021 Race-Free CKD-EPI creatinine equations in South Asian CKD population: A study from Pakistani CKD community cohort

Safdar,

Akram,

Khan

et al. 2024

PLoS ONE

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Introduction South Asian individuals possess a high risk of chronic kidney disease. There is a need to study, evaluate, and compare the newly suggested glomerular filtration rate (eGFR) equations for accurate CKD diagnosis, staging, and drug dosing. This study aimed to (1) evaluate the European Kidney Function Consortium (EKFC), Pakistani CKD-EPI, and 2021 Race-Free CKD-EPI creatinine equation in the South Asian population with CKD and (2) to examine the expected implications on both CKD classification as well as End Stage Renal Disease (ESRD) prevalence across these equations in South Asian population. Methods We carried out a cross-sectional investigation on 385 participants, a CKD cohort ≥ 18 years, at Allama Iqbal Medical College, Jinnah Hospital, Lahore. Serum creatinine was measured by Jaffe’s method and rGFR was measured by inulin clearance. Results Pakistani CKD-EPI has a lower median difference at -1.33 ml/min/1.73m2 elevated precision (IQR) at 2.33 (-2.36, -0.03) and higher P30 value at 89.35% than 2021 CKD-EPI and EKFC equations. The mean difference (ml/min/1.73m2), 95% agreement limits (ml/min/1.73m2) of CKD-EPI PK: -1.18, -6.14, 2021 CKD-EPI: -5.98, -13.24 and EKFC: -5.62, -13.01 (P <0.001). These equations highly correlated to rGFR (P <0.001). An upward re-classification in GFR categories was shown by 2021 CKD-EPI and EKFC compared to the Pakistani CKD-EPI equation. However, there was an exception regarding the G5 category, where an elevated count of 217 (56.36%) was shown for CKD-EPI PK. The prevalence of ESRD was seen in entire age groups and prevailed among females more than in males overall equations. Conclusions Pakistani CKD-EPI exhibited outstanding performance, while 2021 CKD-EPI and EKFC demonstrated poor performances and could not show an adequate advantage for both CKD classification and prevalence of ESRD compared to Pakistani CKD-EPI. Therefore, Pakistani CKD-EPI appears optimal for this region and warrants future validation in other South Asian countries. In contrast, suitable measures must be implemented in Pakistani laboratories.

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Comparison of Pakistani CKD-EPI, new Asian-modified CKD-EPI and revised Lund–Malmö study equations in a South Asian CKD population: a study from a Pakistani CKD cohort

Safdar,

Akram,

Khan

et al. 2023

J Nephrol

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Performance of Serum β2-Microglobulin– and β-Trace Protein–Based Panel Markers and 2021 Creatinine- and Cystatin-Based GFR Estimating Equations in Pakistan

Cited by 7 publications

References 10 publications

Alterations in Glomerular Filtration Rates Using Different Algorithms in the Korean Population Visiting Local Clinics and Hospitals

Alterations in Glomerular Filtration Rates Using Different Algorithms in the Korean Population Visiting Local Clinics and Hospitals

Comparison of EKFC, Pakistani CKD-EPI and 2021 Race-Free CKD-EPI creatinine equations in South Asian CKD population: A study from Pakistani CKD community cohort

Comparison of Pakistani CKD-EPI, new Asian-modified CKD-EPI and revised Lund–Malmö study equations in a South Asian CKD population: a study from a Pakistani CKD cohort

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