New eGFR equations incorporating creatinine and cystatin C without race were more accurate and minimized differences between Black and non-Black participants compared to equations with either marker alone.
Observational (n=17,656)
Yes
Do new eGFR equations without race accurately estimate measured GFR compared to current equations?
New eGFR equations incorporating both creatinine and cystatin C without race provide accurate GFR estimation and reduce differences between Black and non-Black individuals compared to equations using creatinine alone.
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.).
A Thu, study conducted a observational in Chronic kidney disease (n=17,656). New creatinine- and cystatin C-based eGFR equations without race vs. Current eGFR equations with race and new equations with either marker alone was evaluated on Accuracy of eGFR equations compared to measured GFR (percentage within 30% of measured GFR) (95% CI 3.4 to 4.4). New eGFR equations incorporating creatinine and cystatin C without race were more accurate and minimized differences between Black and non-Black participants compared to equations with either marker alone.