Kim Hanah, Hur Mina, Lee Seungho, Lee Gun-Hyuk, Moon Hee-Won, Yun Yeo-Min
Department of Laboratory Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1, Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Korea.
Department of Preventive Medicine, Dong-A University College of Medicine, Busan 49201, Korea.
J Clin Med. 2022 Jul 25;11(15):4323. doi: 10.3390/jcm11154323.
The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is the most commonly used equation for estimated glomerular filtration rate (eGFR). Recently, the European Kidney Function Consortium (EKFC) announced a full-age spectrum equation, and the CKD-EPI announced the CKD-EPI refit equations (CKD-EPI-R). We compared CKD-EPI, EKFC, and CKD-EPI-R equations in a large-scale Korean population and investigated their potential implications for CKD prevalence. In a total of 106,021 individuals who received annual check-ups from 2018 to 2020, we compared the eGFR equations according to the Clinical and Laboratory Standards Institute guidelines. Weighted kappa (κ) agreement was used to compare the potential implications for CKD prevalence across the equations. The median value of eGFR tended to increase in the order of EKFC, CKD-EPI, and CKD-EPI-R equations (92.4 mL/min/1.73 m, 96.0 mL/min/1.73 m, and 100.0 mL/min/1.73 m, respectively). The EKFC and CKD-EPI-R equations showed a very high correlation of eGFR and good agreement for CKD prevalence with CKD-EPI equation (r = 0.98 and 1.00; κ = 0.80 and 0.82, respectively). Compared with the CKD-EPI equation, the EFKC equation overestimated CKD prevalence (3.5%), and the CKD-EPI-R equation underestimated it (1.5%). This is the first study comparing CKD-EPI, EKFC, and CKD-EPI-R equations simultaneously. The EKFC and CKD-EPI-R equations were statistically interchangeable with CKD-EPI equations in this large-scale Korean population. The transition of eGFR equations, however, would lead to sizable changes in the CKD prevalence. To improve kidney health, in-depth discussion considering various clinical aspects is imperative for the transition of eGFR equations.
慢性肾脏病流行病学协作组（CKD-EPI）方程是估算肾小球滤过率（eGFR）最常用的方程。最近，欧洲肾功能联盟（EKFC）公布了一个全年龄谱方程，CKD-EPI也公布了CKD-EPI重新拟合方程（CKD-EPI-R）。我们在一个大规模韩国人群中比较了CKD-EPI、EKFC和CKD-EPI-R方程，并研究了它们对慢性肾脏病患病率的潜在影响。在2018年至2020年接受年度体检的总共106021人中，我们根据临床和实验室标准协会的指南比较了eGFR方程。采用加权kappa（κ）一致性来比较各方程对慢性肾脏病患病率的潜在影响。eGFR的中位数按EKFC、CKD-EPI和CKD-EPI-R方程的顺序呈上升趋势（分别为92.4毫升/分钟/1.73平方米、96.0毫升/分钟/1.73平方米和100.0毫升/分钟/1.73平方米）。EKFC和CKD-EPI-R方程与CKD-EPI方程的eGFR相关性非常高，在慢性肾脏病患病率方面一致性良好（r分别为0.98和1.00；κ分别为0.80和0.82）。与CKD-EPI方程相比，EFKC方程高估了慢性肾脏病患病率（3.5%），而CKD-EPI-R方程低估了患病率（1.5%）。这是第一项同时比较CKD-EPI、EKFC和CKD-EPI-R方程的研究。在这个大规模韩国人群中，EKFC和CKD-EPI-R方程在统计学上与CKD-EPI方程可互换。然而，eGFR方程的转变将导致慢性肾脏病患病率的显著变化。为改善肾脏健康，对于eGFR方程的转变，必须考虑各种临床因素进行深入讨论。
