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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Evaluation of the Chronic Kidney Disease Epidemiology Collaboration equation for estimating the glomerular filtration rate in multiple ethnicities
Kidney International, Volume 79, No. 5, Year 2011
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Description
An equation from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) provides more accurate estimates of the glomerular filtration rate (eGFR) than that from the modification of diet in renal disease (MDRD) Study, although both include a two-level variable for race (Black and White and other). Since creatinine generation differs among ethnic groups, it is possible that a multilevel ethnic variable would allow more accurate estimates across all groups. To evaluate this, we developed an equation to calculate eGFR that includes a four-level race variable (Black, Asian, Native American and Hispanic, and White and other) using a database of 8254 patients pooled from 10 studies. This equation was then validated in 4014 patients using 17 additional studies from the United States and Europe (validation database), and in 1022 patients from China (675), Japan (248), and South Africa (99). Coefficients for the Black, Asian, and Native American and Hispanic groups resulted in 15, 5, and 1% higher levels of eGFR, respectively, compared with the White and other group. In the validation database, the two-level race equation had minimal bias in Black, Native American and Hispanic, and White and other cohorts. The four-level ethnicity equation significantly improved bias in Asians of the validation data set and in Chinese. Both equations had a large bias in Japanese and South African patients. Thus, heterogeneity in performance among the ethnic and geographic groups precludes use of the four-level race equation. The CKD-EPI two-level race equation can be used in the United States and Europe across a wide range of ethnicity. © 2011 International Society of Nephrology.
Authors & Co-Authors
Stevens, Lesley A.
United States, Boston
Tufts Medical Center
Claybon, Marcie A.
United States, Boston
Tufts Medical Center
Schmid, Christopher H.
United States, Boston
Tufts Medical Center
Chen, Jing
United States, New Orleans
Tulane University School of Medicine
Horio, Masaru
Japan, Suita
Graduate School of Medicine
Imai, Enyu
Japan, Suita
Graduate School of Medicine
Nelson, Robert G.
United States, Bethesda
National Institute of Diabetes and Digestive and Kidney Diseases Niddk
Van Deventer, Manuel
South Africa, Johannesburg
University of the Witwatersrand
Wang, Hai Yan
China, Beijing
Peking University First Hospital
Zuo, Li
China, Beijing
Peking University First Hospital
Zhang, Yaping
United States, Boston
Tufts Medical Center
Levey, Andrew S.
United States, Boston
Tufts Medical Center
Statistics
Citations: 424
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1038/ki.2010.462
ISSN:
00852538
e-ISSN:
15231755
Research Areas
Genetics And Genomics
Noncommunicable Diseases
Study Design
Cohort Study
Study Locations
South Africa