Performance of Nuclear Magnetic Resonance-Based Estimated Glomerular Filtration Rate in a Real-World Setting

• Published in: Bioengineering (Basel) Vol. 10; no. 6; p. 717
• Main Authors: Schwäble Santamaria, Amauri, Grassi, Marcello, Meeusen, Jeffrey W, Lieske, John C, Scott, Renee, Robertson, Andrew, Schiffer, Eric
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.06.2023; MDPI
• Subjects: Accuracy; Bias; Bioengineering; Biomarkers; CKD-EPI2021Cr equation; CKD-EPI2021CrCys equation; Clinical medicine; Comorbidity; Creatinine; Cystatin C; eGFR; Epidermal growth factor receptors; GFRNMR equation; Glomerular filtration rate; Inositol; Inositols; Kidney diseases; Kidney transplants; Magnetic resonance imaging; Mathematical analysis; Methods; mGFR; NMR; Nuclear magnetic resonance; Patients; Performance evaluation; Software; Task forces; Testing laboratories; Valine; Germany; United States > US; Indianapolis Indiana; eGFR; NMR; chronic kidney disease; routine sample validation; CKD-EPI2021Cr equation; mGFR; glomerular filtration rate; CKD-EPI2021CrCys equation; CKD; GFRNMR equation
• ISSN: 2306-5354; 2306-5354
• DOI: 10.3390/bioengineering10060717

An accurate estimate of glomerular filtration rate (eGFR) is essential for proper clinical management, especially in patients with kidney dysfunction. This prospective observational study evaluated the real-world performance of the nuclear magnetic resonance (NMR)-based GFR equation, which combines creatinine, cystatin C, valine, and myo-inositol with age and sex. We compared GFR performance to that of the 2021 CKD-EPI creatinine and creatinine-cystatin C equations (CKD-EPI and CKD-EPI ), using 115 fresh routine samples of patients scheduled for urinary iothalamate clearance measurement (mGFR). Median bias to mGFR of the three eGFR equations was comparably low, ranging from 0.4 to 2.0 mL/min/1.73 m . GFR outperformed the 2021 CKD-EPI equations in terms of precision (interquartile range to mGFR of 10.5 vs. 17.9 mL/min/1.73 m for GFR vs. CKD-EPI ; = 0.01) and accuracy (P15, P20, and P30 of 66.1% vs. 48.7% [ = 0.007], 80.0% vs. 60.0% [ < 0.001] and 95.7% vs. 86.1% [ = 0.006], respectively, for GFR vs. CKD-EPI ). Clinical parameters such as etiology, comorbidities, or medications did not significantly alter the performance of the three eGFR equations. Altogether, this study confirmed the utility of GFR for accurate GFR estimation, and its potential value in routine clinical practice for improved medical care.