Lee Seungho, Lee Gun-Hyuk, Kim Hanah, Yang Hyun Suk, Hur Mina
Department of Preventive Medicine, College of Medicine, Dong-A University, Busan 49201, Republic of Korea.
Environmental Health Center for Busan, Dong-A University, Busan 49201, Republic of Korea.
Medicina (Kaunas). 2024 Apr 8;60(4):612. doi: 10.3390/medicina60040612.
: The European Kidney Function Consortium (EKFC) equation has been newly proposed for estimating glomerular filtration rate (eGFR) across the spectrum of age. We compared the EKFC equation with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in a large-scale Korean population. : Using the representative Korean health examination data, the Korea National Health and Nutrition Examination Survey (KNHANES 2008-2021), the records of 91,928 subjects (including 9917 children) were analyzed. We compared the EKFC equation with CKiD, CKD-EPI 2009, and CKD-EPI 2021 equations and investigated their agreement across GFR categories. : In the total population, the CKD-EPI 2021 equation yielded the highest eGFR value, followed by the CKD-EPI 2009 and EKFC equations. In children, the distribution of eGFR differed significantly between the EKFC and CKiD equations ( < 0.001), with a wider range of eGFR values found with the CKiD equation. Each equation showed weak or moderate agreement on the frequency of the GFR category (κ = 0.54 between EKFC and CKD-EPI 2021; κ = 0.77 between EKFC and CKD-EPI 2009). The eGFR values found by the EKFC equation showed high or very high correlations with those by the CKiD, CKD-EPI 2009, and CKD-EPI 2021 equations (r = 0.85, 0.97, and 0.97, respectively). As eGFR values increased, bigger differences were observed between equations. : This large-scale study demonstrates that the EKFC equation would be applicable across the entire age spectrum in Asian populations. It also underscores that national kidney health would be highly affected by an eGFR equation being implemented. Additional investigation and more caution would be warranted for the transition of eGFR equations.
欧洲肾功能联盟（EKFC）新提出了用于估算全年龄段肾小球滤过率（eGFR）的方程。我们在一大群韩国人群中比较了EKFC方程与慢性肾脏病流行病学合作组织（CKD-EPI）的方程。利用具有代表性的韩国健康检查数据，即韩国国家健康与营养检查调查（KNHANES 2008 - 2021），对91928名受试者（包括9917名儿童）的记录进行了分析。我们将EKFC方程与CKiD、CKD-EPI 2009和CKD-EPI 2021方程进行了比较，并研究了它们在不同肾小球滤过率（GFR）类别中的一致性。在总人群中，CKD-EPI 2021方程得出的eGFR值最高，其次是CKD-EPI 2009方程和EKFC方程。在儿童中，EKFC方程和CKiD方程的eGFR分布存在显著差异（<0.001），CKiD方程的eGFR值范围更广。每个方程在GFR类别频率上显示出弱或中等程度的一致性（EKFC与CKD-EPI 2021之间κ = 0.54；EKFC与CKD-EPI 2009之间κ = 0.77）。EKFC方程得出的eGFR值与CKiD、CKD-EPI 2009和CKD-EPI 2021方程得出的eGFR值显示出高度或非常高的相关性（分别为r = 0.85、0.97和0.97）。随着eGFR值的增加，各方程之间的差异更大。这项大规模研究表明，EKFC方程适用于亚洲人群的全年龄段。它还强调，实施的eGFR方程会对国家肾脏健康产生重大影响。对于eGFR方程的转变，需要进行更多调查并更加谨慎。
