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

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...

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Published inBioengineering (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
LanguageEnglish
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
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Abstract 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.
AbstractList 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 GFRNMR equation, which combines creatinine, cystatin C, valine, and myo-inositol with age and sex. We compared GFRNMR performance to that of the 2021 CKD-EPI creatinine and creatinine-cystatin C equations (CKD-EPI2021Cr and CKD-EPI2021CrCys), 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 m2. GFRNMR outperformed the 2021 CKD-EPI equations in terms of precision (interquartile range to mGFR of 10.5 vs. 17.9 mL/min/1.73 m2 for GFRNMR vs. CKD-EPI2021CrCys; p = 0.01) and accuracy (P15, P20, and P30 of 66.1% vs. 48.7% [p = 0.007], 80.0% vs. 60.0% [p < 0.001] and 95.7% vs. 86.1% [p = 0.006], respectively, for GFRNMR vs. CKD-EPI2021CrCys). 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 GFRNMR for accurate GFR estimation, and its potential value in routine clinical practice for improved medical care.
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 NMR equation, which combines creatinine, cystatin C, valine, and myo-inositol with age and sex. We compared GFR NMR performance to that of the 2021 CKD-EPI creatinine and creatinine-cystatin C equations (CKD-EPI 2021Cr and CKD-EPI 2021CrCys ), 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 2 . GFR NMR 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 2 for GFR NMR vs. CKD-EPI 2021CrCys ; p = 0.01) and accuracy (P15, P20, and P30 of 66.1% vs. 48.7% [ p = 0.007], 80.0% vs. 60.0% [ p < 0.001] and 95.7% vs. 86.1% [ p = 0.006], respectively, for GFR NMR vs. CKD-EPI 2021CrCys ). 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 NMR for accurate GFR estimation, and its potential value in routine clinical practice for improved medical care.
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.
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[sub.NMR] equation, which combines creatinine, cystatin C, valine, and myo-inositol with age and sex. We compared GFR[sub.NMR] performance to that of the 2021 CKD-EPI creatinine and creatinine-cystatin C equations (CKD-EPI[sub.2021Cr] and CKD-EPI[sub.2021CrCys] ), 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[sup.2] . GFR[sub.NMR] 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[sup.2] for GFR[sub.NMR] vs. CKD-EPI[sub.2021CrCys] ; p = 0.01) and accuracy (P15, P20, and P30 of 66.1% vs. 48.7% [p = 0.007], 80.0% vs. 60.0% [p < 0.001] and 95.7% vs. 86.1% [p = 0.006], respectively, for GFR[sub.NMR] vs. CKD-EPI[sub.2021CrCys] ). 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[sub.NMR] for accurate GFR estimation, and its potential value in routine clinical practice for improved medical care.
Audience Academic
Author Schiffer, Eric
Scott, Renee
Meeusen, Jeffrey W
Schwäble Santamaria, Amauri
Grassi, Marcello
Lieske, John C
Robertson, Andrew
AuthorAffiliation 3 Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA
2 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
1 Department of Research and Development, Numares AG, 93053 Regensburg, Germany
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Issue 6
Keywords eGFR
NMR
chronic kidney disease
routine sample validation
CKD-EPI2021Cr equation
mGFR
glomerular filtration rate
CKD-EPI2021CrCys equation
CKD
GFRNMR equation
Language English
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These authors contributed equally to this work.
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Snippet An accurate estimate of glomerular filtration rate (eGFR) is essential for proper clinical management, especially in patients with kidney dysfunction. This...
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StartPage 717
SubjectTerms 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
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Title Performance of Nuclear Magnetic Resonance-Based Estimated Glomerular Filtration Rate in a Real-World Setting
URI https://www.ncbi.nlm.nih.gov/pubmed/37370648
https://www.proquest.com/docview/2829699603/abstract/
https://search.proquest.com/docview/2830669845
https://pubmed.ncbi.nlm.nih.gov/PMC10295228
https://doaj.org/article/7f7c3e134c0e48fa90af70b411fd3049
Volume 10
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