Kidney Week

Abstract: TH-PO1028

Impact of Adoption of European Kidney Consortium Equation (EKFC) on CKD Prevalence and CKD Staging in Older Irish Adults

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Tandan, Meera, University of Limerick, Limerick, Limerick, Ireland

Meera Tandan, PhD

• Browne, Leonard, University of Limerick, Limerick, Limerick, Ireland

Leonard Browne, PhD

• Stack, Austin G., University of Limerick, Limerick, Limerick, Ireland

Austin G. Stack, MD, MBChB, MS

Group or Team Name

• National Kidney Disease Surveillance System and Quality Assurance Programme.

Background

The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation tends to overestimate glomerular filtration rate (GFR) and has limitation in younger and older age groups, while the European Kidney Function Consortium (EKFC) full-age spectrum (FAS) correct for these problems and provide better performance in estimating GFR. We compared the 2017 EKFC- FAS(Scr-CysC) equation with 2012 CKD-EPI(Scr-CysC) for estimating CKD prevalence and staging in a national representative sample of older Irish adults.

Methods

We utilised data from The Irish Longitudinal Study on Ageing (2009- 2011), for participants aged 50 to 79 years with complete measurement of serum creatinine (Scr) and Cystatin-C (CysC). Using 2017 EKFC- FAS_(Scr-CysC) and 2012 CKD-EPI_(Scr-CysC), equations eGFR was calculated. CKD was defined as eGFR below 60 ml/min/1.73m². Median eGFR, CKD prevalence, concordance correlation coefficient (CCC), and impact of EKFC equation on GFR category reclassification was examined.

Results

A total of 5,092 participants (53.3% women), median age 61 years were included. CKD prevalence varied significantly from 10.8% (9.9% – 11.8%) using 2021 CKD-EPI _{(Scr -CysC)} to 16.7 % (15.5 - 17.9%) with the 2017 EKFC- FAS_(Scr-CysC) equation. The corresponding numbers of CKD increased from 114,867 to 176,439 individuals respectively. The median eGFR for 2021 CKD-EPI _{(Scr -CysC)} was 82.1 ml/min/1.73m² and 2017 EKFC- FAS_(Scr-CysC) was 74.5 ml/min/1.73m^{<span style="font-size:10.8333px">2</span>}, P<0.001). The net reclassification was 23.1 % based on 2017 EKFC- FAS _(Scr-CysC) equation compared to CKD-EPI 2012 _{(Scr -CysC)} and was towards more worsening CKD stage. The CCC between 2012 CKD-EPI_(Scr-CysC) and 2017 EKFC- FAS_(Scr-CysC) was 0.88 (95% CI, 0.88 - 0.89).

Conclusion

CKD prevalence varies according to eGFR equation with substantially higher numbers of CKD predicted by the European Kidney Function Consortium than CKD-EPI equations. This has direct implications on healthcare planning, resource allocation, and rates of referral to specialist nephrology services in Ireland.

Funding

• Government Support – Non-U.S.