Kidney Week

Abstract: SA-PO767

Estimation of Glomerular Filtration Rate in Multi-centre Chinese Individuals: Comparison of 2017 New FAS (Full Age Spectrum) and 2012 CKD-EPI (CKD Epidemiology Collaboration) Equations

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - III
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Author

• Yong, Zhenzhu, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Zhenzhu Yong,

Background

The recent guidelines recommend using the estimated glomerular filtration rate (eGFR) to evaluate renal function. There are two reported full-age-spectrum (FAS) equations in 2017, which based on serum cystatin C (Cys) concentrations with or without accompanying serum creatinine (Cr) level (FAS_Combi or FAS_Cys). We compared the performance and assessed the applicability of the new FAS formulae with the 2012 CKD-EPI (CKD-EPI_Cys and CKD-EPI_Cr-Cys) equations in Chinese subjects.

Methods

A total of 1184 technetium-99m diethylene-triamine-penta-acetic acid (99mTc-DTPA) renal dynamic images from four different hospitals in China to measure GFR (mGFR) regarded as the referenced method. The bias, precision and accuracy of eGFR and mGFR calculated by four formulae were compared.

Results

The two CKD-EPI equations performed poor in elderly with moderately-severely injured GFR (the proportion of estimated GFR within 30% of referenced GFR, P30, <70%). FAS_Combi formula had less bias (median bias, -2.87), more precision (the inter-quartile range of difference, IQR, 19.01), and more accuracy (P30, 74.16%) in whole cohort, and the difference compared with other three equations was statistically significant. In the rGFR <60 ml/min/1.73m² subgroup, the FAS_Combi formula showed the best performance and the differences were statistically significant. In older subjects, compared with FAS_Cys, CKD-EPI_Cr-Cys and CKD-EPI_Cys, the FAS_Combi formula had relatively less bias (median bias, -8.09 vs. -9.63, -7.52, -11.04, p<0.05), most precise (IQR, 15.18 vs. 16.32, 15.22, 16.63), and most accuracy, P30 was statistically different from the other equations, and achieved a ideal value >70%.

Conclusion

The performance of the FAS_Combi formula is better than that of the CKD-EPI_SCr-Cys formula in the Chinese population, particularly in the elderly. Yet, further modification of FAS equations from a large-scale study could be more suitable for the Chinese population, particularly in older subjects.