[OP.2B.04] CHRONIC KIDNEY DISEASE EPIDEMIOLOGY COLLABORATION-DERIVED GLOMERULAR FILTRATION RATE IS BETTER AT DETECTING PRE-CLINICAL END ORGAN CHANGES THAN OTHER EQUATIONS IN BLACK AFRICANS.

OBJECTIVE: The recent Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for estimated glomerular filtration rate (eGFR) is recommended for use in European populations. However, because the relationship between creatinine and GFR varies between ethnicities, the CKD-EPI equation may not perform as well in African as it does in Caucasian populations. We aimed to identify whether the CKD-EPI equation is more closely associated with end organ changes than previous equations in a group of black African descent.

DESIGN AND METHOD: In 1221 randomly recruited participants of black African ancestry in South Africa, we evaluated serum creatinine concentrations, echocardiographic left ventricular mass index (LVMI) (n = 833), carotid-femoral (aortic) pulse wave velocity (PWV) (n = 1053) and carotid intima-media thickness (IMT)(n = 633). We calculated eGFR from the Jelliffe, 5 Cockcroft-Gault, Salazar-Corcoran, (Modification of Diet in Renal Disease [MDRD] and CKD-EPI equations.

RESULTS: After multivariate adjustments, eGFR calculated from all formulae was inversely associated with LVMI (p < 0.0001), PWV (p < 0.05 to < 0.001), and IMT (p < 0.0001). However, while eGFR determined from all equations was independently associated with LV hypertrophy (LVH) and an increased IMT; CKD-EPI-derived eGFR, but not eGFR determined from alternative equations was independently associated with an increased PWV. Moreover, while eGFR derived from the CKD-EPI and MDRD equations showed a better performance (area under the receiver operator characteristic curve) for the detection of LV hypertrophy (LVH) (p < 0.0005) than eGFR determined from alternative equations, the MDRD equation showed a worse performance for the detection of an increased IMT (p < 0.05 for comparisons of the AUC) than eGFR calculated from alternative equations.

CONCLUSIONS: In black Africans, eGFR derived from the CKD-EPI equation is better at detecting end-organ measures than eGFR derived from either the MDRD or alternative equations. To enhance risk prediction in black African communities eGFR calculated from the CKD-EPI equation may be preferred to other equations.