title: Chronic kidney disease epidemiology collaboration-derived glomerular filtration rate performs better at detecting preclinical end-organ changes than alternative equations in black Africans.
abstract: To identify whether the more recently developed equation for estimated glomerular filtration rate (eGFR) [Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)] is more closely associated with end-organ changes than previous equations in a group of black African descent.
  
  
  
  In 1221 randomly recruited participants of black African ancestry in South Africa, we evaluated serum creatinine concentrations, echocardiographic left ventricular mass index (n = 833), carotid-femoral (aortic) pulse wave velocity (PWV) (n = 1053) and carotid intima-media thickness (n = 633). We calculated eGFR from the Jelliffe, five Cockcroft-Gault, Salazar-Corcoran, Modification of Diet in Renal Disease (MDRD) and CKD-EPI equations.
  
  
  
  After multivariate adjustments, eGFR calculated from all formulae was inversely associated with left ventricular mass index (P < 0.0001) and PWV (P < 0.05 to <0.001), but not with carotid intima-media thickness (P > 0.08). However, although eGFR determined from all equations except Cockcroft-Gault lean body weight or adjusted body weight was independently associated with left ventricular hypertrophy (n = 390 of 833), CKD-EPI-derived eGFR, but not eGFR determined from alternative equations, was independently associated with an increased PWV (n = 88 of 1053). eGFR derived from the CKD-EPI and MDRD equations showed a better performance (area under the receiver operator characteristic curve) for the detection of left ventricular hypertrophy (P < 0.0005) than eGFR determined from alternative equations.
  
  
  
  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.
authors.affiliation: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Hendrik L
authors.initials: HL
authors.lastname: Booysen
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Woodiwiss
authors.forename: Andrew
authors.initials: A
authors.lastname: Raymond
authors.forename: Pinhas
authors.initials: P
authors.lastname: Sareli
authors.forename: Hon-Chun
authors.initials: HC
authors.lastname: Hsu
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Dessein
authors.forename: Gavin R
authors.initials: GR
authors.lastname: Norton
mesh_terms: D000328:Adult; D019540:Area Under Curve; D044383:Black People; D001835:Body Weight; D059168:Carotid Intima-Media Thickness; D003404:Creatinine / Q000097:blood; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D055641:Mathematical Concepts; D008875:Middle Aged; D009929:Organ Size; D063177:Pulse Wave Analysis; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D013019:South Africa
chemical_list: D003404:Creatinine