Comparisons Of Different Equations For Estimated Glomerular Filtration Rate In Chinese Han Patients With Chronic Kidney Disease In Real World

Objective:Aim To understand the agreement,precision and accuracy between other estimated glomerular filtration rate（eGFR）equations and the Chronic Kidney Disease Epidemiology Collaboration（CKD-EPI）creatinine-cystatin C equation（EPI_Cr_CysC）.Methods:We conducted a cross-sectional study research of 1913 CKD patients.The eGFRs were calculated separately by creatinine clearance rate and Cockcroft-Gault equation corrected for standard body surface area（Ccr_BSA and eCcr_BSA）,CKD-EPI_creatinine equation（EPI_Cr）,CKD-EPI_cystatin C equation（EPI_CysC）,EPI_Cr_CysC equation,Modification of Diet in Renal Disease equation with standardized serum creatinine（MDRD）and full-age-spectrum creatinine equation（FAS）.And EPI_Cr_CysC equation was used as the reference.Results:When compared with EPI_Cr_CysC equation,EPI_Cr equation achieved the highest agreement in eGFR estimates[Lin’s concordance correlation coefficient（95%CI）,0.936（0.930,0.941）].And eCcr_BSA and EPI_Cr equation achieved the first and second highest percent agreement in accurate classification of the CKD stage[percent agreement,72.55%VS 71.25%].MDRD equation got the minimal bias and was closely followed by EPI_Cr equation[median difference（95%CI）,-1.3（-2.0,-0.8）VS 2.5（1.7,3.3）mL/min/1.73m²].EPI_CysC and EPI_Cr equations achieved the first and second highest precision[IQR of the difference（95%CI）,12.2（11.6,12.9）VS.15.5（14.7,16.3）mL/min/1.73m²].EPI_Cr and MDRD equations performed similarly and tied for first place in 30%accuracy[1-P₃₀（95%CI）,18.6（16.9,20.4）%VS 18.6（16.8,20.3）%].Conclusion:For assessment of renal function,EPI_Cr equation performed the best and remained an acceptable alternative to EPI_Cr_CysC equation in the absence of cystatin C.