Estimation of Glomerular Filtration Rate Using the New Ekfc Equation in Healthy and Chronic Kidney Disease Adult Subjects from Sub-Saharan Africa

Abstract

Introduction: Since the publication of the first equation for estimate creatinine clearance in 1957, several other equations estimating glomerular filtration rate have followed in succession. To date, a new equation has been published by the European Kidney Function Consortium (EKFC) in 2021, which would have the advantage of being adaptable to any type of population. In this study, we aimed to evaluate the performance of this new equation in our black African population of healthy subjects and subjects with chronic kidney disease. Material and Methods: This was a cross-sectional study involving 192 healthy subjects and 183 subjects with chronic kidney disease. Plasma iohexol clearance (mGFR) constituted́ the reference method used to measure glomerular filtration rate and allowed evaluation of all equation variants (EKFC crea, EKFC cys, EKFC crea-cys). Equation performance was studied by calculating the 95% CI bias, the interquartile range (25% percentile, 75% percentile) and the 30% accuracy (P30) compared with the reference method. Results: All EKFC variants in both populations (healthy subjects and chronic kidney disease subjects) had biases below 5 ml/min/1.73 m2. Biases were therefore acceptable. On the other hand, P30s were less good in subjects with chronic kidney disease. Conclusion: Thus, the EKFC equation performs well in the healthy population, but its evaluation in the chronic kidney disease population needs to be strengthened on the basis of larger cohorts.