DETERMINATION OF DFG IN A BLACK AFRICAN POPULATION WITH CHRONIC KIDNEY DISEASE IN 2023: COMPARISON OF THE PERFORMANCE OF 11 ESTIMATION EQUATIONS

Abstract

Introduction: Chronic kidney disease is a public health problem. To date, several equations have been proposed for its diagnosis, but these remain relatively approximate. In Africa, in the absence of specific recommendations, these formulas are used with the consequent risk of diagnostic bias, whereas in recent years, studies carried out in Africa have questioned the relevance of the ethno-racial factor used in certain equations in a healthy population. The aim of this study was therefore to evaluate 11 equations currently in use in black African chronic kidney disease patients. Material and Methods: This was an analytical cross-sectional study involving 183 chronically ill renal patients in whom GFR was measured by iohexol plasma clearance used as a reference and estimated by 11 current equations. The performance of the current equations was determined by calculating the median bias, interquartile range and accuracy at P30 in comparison with the reference method. Results: EKFC equations showed the best bias and accuracy at 30%. The 2021 CKD epi equations have not proven their performance in our African population of chronic kidney disease subjects. The use of cystatin as a biomarker added value to each type of equation. Unfortunately, the 30% accuracies of all equations remain below 75% in the chronic kidney disease population. Conclusion: The equation best suited in 2023 to our sick black African population is the EKFC equation and its variants. Although it remains the best-performing, the 30% accuracy remains below 75%.