Ann Lab Med.  2017 Sep;37(5):371-380. 10.3343/alm.2017.37.5.371.

Accuracy Assessment of Five Equations Used for Estimating the Glomerular Filtration Rate in Korean Adults

• Jeong TD
• Cho EJ
• Lee W
• Chun S
• Hong KS
• Min WK

• KMID: 2383912
• DOI: http://doi.org/10.3343/alm.2017.37.5.371

Abstract

BACKGROUND
We aimed to assess the performance of the five creatinine-based equations commonly used for estimates of the glomerular filtration rate (eGFR), namely, the creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPIcr), Asian CKD-EPI, revised Lund-Malmö (revised LM), full age spectrum (FAS), and Korean FAS equations, in the Korean population.
METHODS
A total of 1,312 patients, aged 20 yr and above who underwent ⁵¹Cr-EDTA GFR measurements (mGFR), were enrolled. The bias (eGFR-mGFR) and precision (root mean square error [RMSE]) were calculated. The accuracy (P30) of four eGFR equations was compared to that of the CKD-EPIcr equation. P30 was defined as the percentage of patients whose eGFR was within±30% of the mGFR.
RESULTS
The mean bias (mL·min⁻¹·1.73 m⁻²) of the five eGFR equation was as follows: CKD-EPIcr, -0.6; Asian CKD-EPI, 2.7; revised LM, -6.5; FAS, -2.5; and Korean FAS, -0.2. The bias of the Asian CKD-EPI, revised LM, and FAS equations showed a significant difference from zero (P<0.001). The RMSE values were as follows: CKD-EPIcr, 15.6; Asian CKD-EPI, 15.6; revised LM, 17.9; FAS, 16.3; and Korean FAS, 15.8. There were no significant differences in the P30 except for the Asian CKD-EPI equation: CKD-EPIcr, 76.6%; Asian CKD-EPI, 74.7%; revised LM, 75.8%; FAS, 76.0%; and Korean FAS, 75.8%.
CONCLUSIONS
The CKD-EPIcr and Korean FAS equations showed equivalent analytical and clinical performances in the Korean adult population.

Keyword

Accuracy; Comparison; Creatinine; Equation; Glomerular filtration rate

MeSH Terms

Adult*
Asian Continental Ancestry Group
Bias (Epidemiology)
Cooperative Behavior
Creatinine
Epidemiology
Glomerular Filtration Rate*
Humans
Renal Insufficiency, Chronic
Creatinine

Figure

• 

  Fig. 1 Kernel density plot of glomerular filtration rate (GFR).Abbreviations: mGFR, measured GFR; FAS, full age spectrum equation; Korean FAS, Korean version of FAS equation; CKD-EPIcr, creatinine-based Chronic Kidney Disease Epidemiology Collaboration equation; revised LM, revised Lund–Malmö equation.

• 

  Fig. 2 Comparison between estimated glomerular filtration rate (eGFR) and measured GFR (mGFR). (A and B) Creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPIcr) equation; (C and D) Asian CKD-EPI equation; (E and F) Revised Lund–Malmö (Revised LM) equation; (G and H) Full-age spectrum (FAS) equation; (I and J) Korean FAS equation. The gray line in the scatter plot represents the identical line. Solid and dashed black lines in the Bland–Altman plot represent the mean and 95% limits of agreement (LoA) of bias, respectively.Abbreviation: Lin's CCC, Lin's concordance correlation coefficient.

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