2024
DOI: 10.1007/s40620-023-01883-7
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Evaluation of risk stratification for acute kidney injury: a comparative analysis of EKFC, 2009 and 2021 CKD-EPI glomerular filtration estimating equations

Jeong Min Cho,
Jung Hun Koh,
Minsang Kim
et al.

Abstract: Background The adoption of the 2021 CKD-EPIcr equation for glomerular filtration rate (GFR) estimation provided a race-free eGFR calculation. However, the discriminative performance for AKI risk has been rarely validated. We aimed to evaluate the differences in acute kidney injury (AKI) prediction or reclassification power according to the three eGFR equations. Methods We performed a retrospective observational study within a tertiary hospital from 2011 to… Show more

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(3 citation statements)
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“…The 2006 MDRD equation showed the lowest correlation coefficient with age in this study, aligning with previous studies conducted in healthy subjects [23]. The ranking from the highest to the lowest of the median (or mean) eGFR levels calculated from each equation is consistent with prior findings reported in the Korean population under various clinical settings, in other ethnic groups (non-black individuals) and in the Korea National Health and Nutrition Examination Survey 2019 data [5,11,13,[22][23][24][25][26][27]. Notably, the 2006 MDRD and 2021 EKFC equations yielded the lowest eGFR levels compared to the other equations, potentially leading to an underestimation of CKD grades in the Korean adult population [13,[22][23][24][25][26][27].…”
Section: Discussionsupporting
confidence: 90%
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“…The 2006 MDRD equation showed the lowest correlation coefficient with age in this study, aligning with previous studies conducted in healthy subjects [23]. The ranking from the highest to the lowest of the median (or mean) eGFR levels calculated from each equation is consistent with prior findings reported in the Korean population under various clinical settings, in other ethnic groups (non-black individuals) and in the Korea National Health and Nutrition Examination Survey 2019 data [5,11,13,[22][23][24][25][26][27]. Notably, the 2006 MDRD and 2021 EKFC equations yielded the lowest eGFR levels compared to the other equations, potentially leading to an underestimation of CKD grades in the Korean adult population [13,[22][23][24][25][26][27].…”
Section: Discussionsupporting
confidence: 90%
“…Although the eGFR levels calculated from the 2009 CKD-EPI Cr and 2021 CKD-EPI Cr equations appear comparable (Figure 3j), the agreement in CKD categories shows a higher proportion of underestimation compared to the 2009 CKD-EPI Cr equation. These findings align with previous recommendations regarding the cautious use of newly developed equations in Korean subjects, as the 2009 CKD-EPI Cr and 2012 CKD-EPI Cr & Cys-C equations demonstrated better performance in the Korean population [3,13,25]. This suggests that, while quantitative eGFR level differences were observed, the clinical impact on qualitative CKD categorization may differ from the impact on the quantitative levels [9,13,29].…”
Section: Discussionsupporting
confidence: 88%
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