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Is race adjustment necessary to estimate glomerular filtration rate in South Brazilians?
Escott, Gustavo Monteiro; Zingano, Carolina Pires; Ferlin, Elton; Garroni, Marcelo; Thomé, Fernando S; Veronese, Francisco José Veríssimo; Silveiro, Sandra Pinho.
Afiliação
  • Escott GM; Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2º andar, Porto Alegre, RS, 90035-003, Brazil. gustavo.escott@gmail.com.
  • Zingano CP; Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. gustavo.escott@gmail.com.
  • Ferlin E; Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2º andar, Porto Alegre, RS, 90035-003, Brazil.
  • Garroni M; Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
  • Thomé FS; Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
  • Veronese FJV; Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2º andar, Porto Alegre, RS, 90035-003, Brazil.
  • Silveiro SP; Diabetes and Metabolism Group, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
J Nephrol ; 2024 Jun 24.
Article em En | MEDLINE | ID: mdl-38913268
ABSTRACT
BACKGROUND AND

AIMS:

Race coefficients (RC) in equations to estimate glomerular filtration rate (GFR) have been highly questioned. We aimed to evaluate the performance of three equations, namely 2009 Chronic Kidney Disease Epidemiology Collaboration (2009 CKD-EPI), 2021 CKD-EPI, and European Kidney Function Consortium (EKFC) in self-reported Black and White Brazilians. MATERIALS AND

METHODS:

Our cross-sectional study compared estimated GFR (eGFR) with 51Cr-EDTA measured GFR (mGFR) in healthy adults, patients with type 2 diabetes mellitus with or without chronic kidney disease (CKD), and in non-diabetic individuals with CKD. The performance of these equations was assessed using Bland-Altman plots, Lin's concordance correlation coefficient (CCC), bias, P30, and P15 accuracy.

RESULTS:

Three hundred six White adults (aged 53 ± 17 years, 55% women, mean mGFR 83 ± 32 mL/min/1.73 m2) and 48 Black participants (aged 53 ± 17 years, 58% women, mGFR 90 ± 34 mL/min/1.73 m2) were included. No equation achieved the desirable P30 accuracy value of 90%, neither in White (2009 CKD-EPI78%, 2021 CKD-EPI76% and EKFC77%, p = 0.368) nor in Black volunteers (respective values of 77%, 75%, and 77%; p = 0.882). The 2009 CKD-EPI showed the best performance in Black participants (bias 4.04; CCC 0.848), whereas the 2021 CKD-EPI performed better in Whites, with smaller bias (1.45), and better concordance correlation coefficient (0.790). The EKFC presented the worst performance. All equations underdiagnosed advanced CKD in White participants, but not in Black.

CONCLUSIONS:

The 2021 CKD-EPI does not outperform the 2009 CKD-EPI. Instead, it underestimated the occurrence of CKD in White participants. Thus, we do not recommend replacing the 2009 with the new 2021 CKD-EPI in the Brazilian population.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Itália
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Itália