Creatinine-based European Kidney Function Consortium equation is superior to the Chronic Kidney Disease Epidemiology Collaboration equation for mortality risk stratification in general non-Black population

Aims: A recent study demonstrated that the new modified estimated glomerular filtration rate (eGFR) equation proposed by the European Kidney Function Consortium (EKFC) was more accurate and precise than the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. This study aimed to compare the prognostic values of these two creatinine-based equations with regard to all-cause and cardiovascular mortality in general non-Black population.

Methods and results: A population-based cohort study was conducted using data from the National Health and Nutrition Examination Survey database from 1999 to 2018, and 38 983 non-Black individuals aged 20 years or older without a history of dialysis were enrolled. Among 38 983 participants, 6103 deaths occurred after a median follow-up duration of 112 months, of which 1558 deaths were due to cardiovascular causes. There were U-shaped relations between the eGFR values and the risk of all-cause and cardiovascular mortality. The areas under the curves for the EKFC were significantly higher than those for the CKD-EPI equation for all-cause and cardiovascular mortality. The integrated discrimination improvement for the EKFC equation compared with the CKD-EPI equation was 2.40% and 1.26% for 10-year all-cause and cardiovascular mortality; the net reclassification improvement for the EKFC equation compared with the CKD-EPI equation was 8.67% and 11.13% for 10-year all-cause mortality and cardiovascular mortality.

Conclusion: Creatinine-based EKFC equation outperformed the CKD-EPI equation for the prediction of long-term all-cause and cardiovascular mortality in the general non-Black population.