No race-ethnicity adjustment in CKD-EPI equations Is required for estimating glomerular filtration rate in the brazilian population

• Autor(a) principal: Santos, Andressa Borges
• Data de Publicação: 2020
• Outros Autores: Garcia, Suzane, Eduardo, José C. C., Mesquita, Claudio Tinoco, Lugon, Jocemir R., Matos, Jorge P. Strogoff
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da Universidade Federal Fluminense (RIUFF)
• Texto Completo: http://app.uff.br/riuff/handle/1/28845
• topic: Taxa de filtração glomerular; Raça; Etnia; Doença renal crônica; Brasileiro

Background. Glomerular filtration rate (GFR) is usually estimated from equations using serum creatinine (sCr), with adjustment for gender, age, and race (black or nonblack). -e Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) is the preferred equation for adults, but it was validated for the United States population. We intended to evaluate if the race-ethnicity adjustment proposed for the sCr-based CKD-EPI equations is appropriate for the Brazilian population. Methods. CKD outpatients had blood samples collected for determination of sCr and serum cystatin C (sCys) levels. GFR was measured (mGFR) by plasma clearance of 51Cr-EDTA and used as the reference. We compared values of mGFR and estimated GFR (eGFR) by CKD-EPIequations based on sCr (eGFRCr) and on the combination of sCr and sCys (eGFRCr-Cys). For African Brazilian patients, eGFR was calculated either without or with race adjustment. Accuracy was considered acceptable if the difference between the values of eGFR and mGFR was ≤30% (P30). Results. 100 patients were enrolled (58 ± 14 years, 46% male, 39% white and 61% African Brazilian). Mean mGFR was 46.7 ± 29.2 ml/min/1.73m2. Mean eGFRCr and eGFRCr-Cys without race adjustment were 47.8 ± 30.1 ml/min/1.73m2 and 46.4 ± 30.3 ml/min/1.73m2, respectively. -e corresponding P30 accuracy values were 79.0% and 83.0%. In the African Brazilian subgroup, values for mean mGFR and eGFRCr either without or with race adjustment were 49.8 ± 32.2 ml/min/1.73m2, 50.4 ± 32.7 ml/min/1.73m2, and 58.4 ± 37.9 ml/min/1.73m2 (P < 0.001 vs. mGFR), respectively. P30 accuracy values for eGFRCr either without or with race adjustment were 75.4% and 67.2%, respectively. Conclusions. -e use of CKD-EPI equations without race-ethnicity adjustment seems more appropriate for the Brazilian population.