Evaluation of the New Race-Free 2021 CKD-EPI Equations Incorporating Creatinine and Cystatin C as a Marker of Glomerular Filtration Rate in Renal Transplant Recipients

Afshan Bibi; Muhammad Aamir; Saima Bashir; Khalid Mehmood Raja; Saba Umar; Uzma Naeem

doi:10.51253/pafmj.v76iSUPPL-9.11106

Authors

Afshan Bibi Department of Chemical Pathology, Combined Military Hospital, Tarbela/National University of Medical Sciences (NUMS) Pakistan
Muhammad Aamir Department of Chemical Pathology, Shifa International Hospital, Islamabad Pakistan
Saima Bashir Department of Chemical Pathology, Army Medical College, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Khalid Mehmood Raja Department of Medicine, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Saba Umar Department of Medicine, Riphah International Hospital, Islamabad Pakistan
Uzma Naeem Department of Chemical Pathology, Army Medical College, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-9.11106

Keywords:

CKD-EPI 2021equations, Creatinine, Cystatin C, eGFR, Race-Free

Abstract

Objective: To evaluate bias and accuracy of race-free 2021 CKD-EPI equations in our adult population of renal transplant recipients.

Study Design: Cross-sectional study.

Place and Duration of Study: Chemical pathology and Endocrinology Departments of Armed Forces Institute of Pathology in collaboration with Armed Forces Institute of Urology, Rawalpindi, Pakistan, from Dec 2021 to May 2022.

Methodology: Fifty post-transplant adult patients with stable renal functions were included. Estimated GFR (eGFR) was calculated by the new CKD-EPI equations (2021), incorporating creatinine alone and creatinine combined with cystatin C, classical (2009) creatinine equation, cystatin C (2012) and creatinine combined with cystatin C (2012) equations with help of eGFR calculator app by National Kidney Foundation. GFR was measured by creatinine clearance. Performance of new CKD-EPI equations was evaluated in comparison with old CKD-EPI equations taking measured GFR (mGFR) by creatinine clearance as gold standard.

Results: The 2021 race free creatinine equation showed the largest mean bias (17.6 ml/min/1.73m2) followed by 2009 creatinine equation (11.06 17.6 ml/min/1.73m2). CKD-EPI 2012 equation incorporating Cystatin C alone performed the best with the least mean bias of 4.3ml/min/1.73m2. Similarly, 2012 equation incorporating both creatinine and cystatin C showed better results (mean bias = 7.3 ml/min/1.73m2) than new equation incorporating both cystatin C and creatinine (mean bias = 9.78 ml/min/1.73m2).

Conclusion: The new race free 2021CKD-EPI creatinine equation showed highest bias, least precision and weak positive correlation with mGFR as compared to previously used eGFR equations in our cohort of renal transplant recipients.

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