INTRODUCTION
The automatic reporting of estimated glomerular filtration rate (eGFR) for all creatinine (Pcr) determination is mandatory, and the CKD-EPI 2009 formula1 is considered the most accurate. However, CKD-EPI is inadequate in young adults and is debated in the elderly. The European-Kidney-Function-Consortium (EKFC) equation2 provides continuous eGFR from 2-year-olds to elderly. The authors’ objective was to assess the impact of using the EKFC compared to CKD-EPI.
METHODS
The authors retrieved data from the laboratory database, including gender, age, and Pcr for all patients over 18 years in November 2023. eGFR was calculated using the CKD-EPI and the EKFC. Results were expressed as the mean bias between EKFC and CKD-EPI (as reference) according to age groups.
RESULTS
A total of 10,066 patients (50.5% females; mean age 56.0±21.2 years [18.0–106.7]) underwent Pcr determination (mean 84.7±72.3 µmol/L) with 1,706 (16.9%) and 405 (4.0%) having a GFR <60 or <30 mL/min/1.73 m2, respectively. Bias EKFC-CKD-EPI was small (-3.3±3.1 mL/min/1.73 m2) in the 40–70 years group, whereas it was increased both in young adults and elderly (-16.4±5.1, -6.2±4.6, and -6.9±3.6 mL/min/1.73 m2 in the 18–25, 25–40, and >70 years groups, respectively). The proportion of misclassified patients with GFR <60 mL/min/1.73 m2 is small, except in the elderly (9.3%) when CKD-EPI is considered less accurate.
CONCLUSION
The use of EKFC in laboratories to estimate eGFR offers continuous GFR estimation from 2-year-olds to the elderly, and could be an alternative to CKD-EPI. The automatic reporting of eGFR with EKFC by laboratories could allow for an earlier diagnosis of CKD, and initiation of nephroprotection in young adults and the elderly.
