ECE2022 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (318 abstracts)
Is the 2009 CKD-EPI more accurate with or without the race coefficient for black adults from outside the United States?
Carolina Zingano 1 , Gustavo Monteiro Escott 1 , Bruna Martins Rocha 1 , Indianara Franciele Porgere 1 , Candice Cristine Moro 1 , Pierre Delanaye 2,3 & Sandra Pinho Silveiro 1,4
1Federal University of Rio Grande do Sul, Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Brazil; 2ULiège, Department of Nephrology-Dialysis-Transplantation, Liège, Belgium; 3University Hospital of Nimes, Department of Nephrology-Dialysis-Apheresis, Nîmes, France; 4Hospital de Clínicas de Porto Alegre, Endocrine Unit, Porto Alegre, Brazil
Introduction: Diabetes is the leading worldwide cause of chronic kidney disease, which is diagnosed by measuring albuminuria and estimating glomerular filtration rate (GFR) with creatinine-based formulas, such as the 2009 CKD-EPI developed in the United States of America (USA). Nonetheless, the race coefficient (RC), present in the 2009 CKD-EPI, may overestimate GFR in other countries.
Aim: The goal of this systematic review and meta-analysis was to assess the accuracy, measured by P30 (percentage of estimated results within 30% of measured GFR), of the 2009 CKD-EPI in estimating GFR with and without the RC in black adults outside the USA.
Methods: A bibliographical search of PubMed and Embase was performed and last updated on December 5th, 2021. Eligible studies included 2009 CKD-EPI P30 accuracy values with or without the RC for black adults outside the USA. Studies which used inadequate measuring methods of GFR were excluded. Our study is registered in PROSPERO (CRD42021236613) and reported according to the PRISMA-DTA guideline. The data was extracted by independent pairs of reviewers and was pooled using a random-effects model.
Results: Our systematic review included 11 studies, with a total of 1834 black adults from Africa, South America and Europe. Eliminating the RC in the 2009 CKD-EPI formula significantly increased P30 accuracy results in these populations (from 61.9% [95% CI, 53% to 70%] to 72.9% [95% CI, 66.7% to 78.3%]; P=0.03).
Conclusion: Outside the USA, the 2009 CKD-EPI should not be used with the RC, even though it is not sufficiently accurate (P30 below 75%). Thus, we endorse KDIGO guidelines to use exogenous filtration markers in black patients outside the USA when a more accurate estimation of GFR may impact clinical conduct.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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