3 years ago

Comparisons of Five Equations Used for Estimating the Glomerular Filtrations Rate in Chinese Adults

shuai fu, Min Yang, Si Xu, Sha Wu, Xiao Xiao, Yugang Hu, Xiaoning Li


We aimed to assess the performance of revised MDRD, CKD-EPI, BIS, FAS and XiangYa equation in Chinese adults 


We collected blood biochemical data of 623 chinese adult hospitalised patients within 48 hours before they underwent 99m Tc-DTPA GFR measurement. We computed the bias (mGFR-eGFR), the precision (IQR) ,the accuray (P30)and root mean square error (RMSE) relative to mGFR of each equation to evaluate performance. The ROC curves, Kappa value of McNemar test, Bland-Altman plot and the Intraclass correlation coefficient (ICC) were used to evaluate diagnostic accuracy and concordance.


Totally, the FAS combined Scr and cysC equation performed supreme accuracy(P30=57.5%, RMSE=19.26), the cysC-based equation performed superior to Scr-based equation. Detailed P30 of the CKD-EPI cysC , FAS cysC , MDRD, CKD-EPI Scr-cysC , CKD-EPI Scr , FAS Scr , XiangYa was 56.7%, 56.0%, 53.5%, 52.2%, 48.8%, 51.4%, 43.0%. The CKD-EPI cysC equation showed the lowest bias and the highest accuracy(bias=-2.23, P30=57.4%) in GFR<60ml/min/1.73m 2 , followed by the FASscr-cysC equation(bias=-6.89, P30=55.4%). The XiangYa equation perfomed best in GFR≥60ml/min/1.73m 2 while worst in GFR<60 ml/min/1.73m 2 with bias(-5.79 vs -19.05), IQR(18.21 vs 10.85), P30(86.2% vs 21.1%), RMSE(16.68 vs 21.34). The CKD-EPI cysC equation had the lowest bias and the best accuracy(bias=-2.23, P30=59.4%) in age ≥70 years adults, followed by the FAS Scr-cysC equation equivalented to BIS-2 Scr-cysC equation(bias -5.33 vs -4.90, P30=57.3%), while the XiangYa equation performed worstly (bias=-20.39, P30=26.6%). Best ROC AUC was gaven by the FAS Scr-cysC equation(0.951),so was it had the highest Kappa value(0.364). The lowest Bias showed in Bland-Altman plot was the CKD-EPI cysC equation(bias=7.46). The highest ICC value was gaven by the FAS Scr-cysC equation(0.921). Secondly, it was the XiangYa equation with the ICC of 0.912.


The FAS Scr-cysC equation is verified most suitable and simpler applied to Chinese population. The CKD-EPI cysC equation is appropriate used in moderately and severely injured GFR(CKD3-5stage) and Seniors over 70 years old. The XiangYa equation performed perfectly in slightly injured GFR (CKD1-2stage), while further verification of XiangYa equation in multiple region need to carried out especially in moderately and severely injured GFR and older adults.

Publisher URL: https://www.researchsquare.com/article/rs-17896/v1

DOI: 10.21203/rs.3.rs-17896/v1

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