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The Xiangya equation could not replace the Asian modified CKD-EPI equation in estimating glomerular filtration rate in Chinese patients with chronic kidney disease

  • Nephrology - Original Paper
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Abstract

Background

To evaluate the clinical practicability of the Xiangya equation in estimating glomerular filtration rate (GFR) and compare with the Asian modified Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation, assessing whether the Xiangya equation could replace the Asian modified CKD-EPI equation as the preferred method for predicting GFR in the Chinese CKD patients in an external validation study.

Methods

The GFR was determined simultaneously by two methods: (a) the Asian modified CKD-EPI equation (GFRCKD-EPI); (b) the Xiangya equation (GFRXiangya); diagnostic performance of the two models was compared by the regression analysis, the Bland–Altman plot, bias, precision and P30 under the background of 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) dual plasma sample clearance method as reference method for GFR measurement (mGFR).

Results

A total of 158 Chinese CKD patients were included in our external study. The GFRXiangya was highly related with mGFR, with the correlation coefficient of 0.92. The regression equation was GFRXiangya = 0.55*mGFR + 28.25, where the regression coefficient was far away from one and the intercept was wide. Compared with the Asian modified CKD-EPI equation, the performance of the Xiangya equation demonstrated a poorer bias (9.5 vs − 3.3 ml/min/1.73 m2, P < 0.001), an inferior precision (23.9 vs 13.0 ml/min/1.73 m2, P < 0.001), a lower P30 (51.3% vs 73.4%, P < 0.001) and a wider 95% limit of agreement in Bland–Altman analysis (65.0 vs 44.9 ml/min/1.73 m2).

Conclusion

Due to relatively inferior performance, the Xiangya equation could not replace the Asian modified CKD-EPI equation in estimating GFR in Chinese patients with chronic kidney disease in our external cohort.

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Funding

This paper was partially supported by Health and Family Planning Commission of Hebei Province (20190619).

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Author notes

  1. Wei Liu and Li Zhao contributed to the work equally and should be regarded as co-first authors.

Authors and Affiliations

  1. Department of Nuclear Medicine, The Third Hospital of Hebei Medical University, No.139, ZiQiang Road, Shijiazhuang, 050051, Hebei Province, People’s Republic of China

    Wei Liu, Jian-min Huang, Ling-ge Wei, Mei-chao Guan & Peng Xie

  2. Department of Laboratory Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People’s Republic of China

    Li Zhao

  3. Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People’s Republic of China

    Feng Gao

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  1. Wei Liu
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Contributions

WL: provided and used the software. PX and LZ: conceived and designed the experiments. PX, JMH, LGW, MCG and FG: performed the experiments. WL and LZ: wrote the paper.

Corresponding author

Correspondence to Peng Xie.

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Liu, W., Zhao, L., Huang, Jm. et al. The Xiangya equation could not replace the Asian modified CKD-EPI equation in estimating glomerular filtration rate in Chinese patients with chronic kidney disease. Int Urol Nephrol 54, 3025–3031 (2022). https://doi.org/10.1007/s11255-022-03248-8

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  • DOI: https://doi.org/10.1007/s11255-022-03248-8

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