Kidney Week

Abstract: FR-PO1138

Comparison of Creatinine-Based Glomerular Filtration Rate Equations for Mortality Prediction in Korean Population: A Retrospective Kangbuk Samsung Health Cohort Study

Session Information

• CKD: Kidney Function and Extrarenal Complications
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Huh, Daseul, Kangbuk Samsung Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Daseul Huh, DrMed

• Yang, Jihyun, Kangbuk Samsung Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Jihyun Yang, MD, PhD

• Hyun, Young Youl, Kangbuk Samsung Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Young Youl Hyun, MD, PhD

• Lee, Kyu-Beck, Kangbuk Samsung Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Kyu-Beck Lee, MD

Background

Several creatinine-based equations have been developed for estimating glomerular filtration rate (GFR). However, their relative performance for mortality prediction in Koreans is unclear, thus the creatinine-based equations have been evolving. We aim to compare the CKD-EPI 2009 and 2021 (race-free) equations to the European Kidney Function Consortium (EKFC) equation for mortality prediction in a large Korean cohort.

Methods

We analyzed 670,320 participants who underwent a comprehensive health examination, enrolled in Kangbuk Samsung Health Cohort from January 1, 2002 to December 31, 2019 and followed them up for mortality until December 2019.

Results

The participants’ median follow-up period was 8.8 years, mean age was 39.8 years old (minimum 18, maximum 97), and 53.6% were male. Mean eGFR using 2009 CKD-EPI was 95.1 ml/min/1.73m², 100.6 ml/min/1.73m² using 2021 CKD-EPI, 94.0 ml/min/1.73m² using EKFC. The EKFC equation had the highest discriminatory power to predict all-cause mortality (Harrell’s C index of EKFC = 0.694 (95% confidence interval 0.687-00.701), 2021 CKD-EPI = 0.665 (95% CI 0.659-0.672), 2009 CKD-EPI = 0.667 (0.636-0.648), p < 0.001) and cardiovascular disease (CVD) mortality (Harrell’s C index of EKFC = 0.745 (95% CI 0.728-0.762), 2021 CKD-EPI = 0.716 (95% CI 0.699-0.732), 2009 CKD-EPI = 0.716 (95% CI 0.699-0.732)).

Conclusion

In this large cohort of Koreans, the EKFC equation showed superior discrimination for predicting all-cause and CVD morality versus CKD-EPI equations. These findings support the adoption of the EKFC equation for GFR estimation and mortality risk prediction in this population.