COMPARATIVE EVALUATION OF EGFR EQUATIONS FOR RENAL FUNCTION ASSESSMENT IN PREGNANT WOMEN: A CROSS-SECTIONAL STUDY IN VIETNAM

Introduction:

Routine assessment of renal function is commonly performed using estimated glomerular filtration rate (eGFR), with particular emphasis on the CKD-EPI SCr-SCysC 2021 equation. However, physiological changes during pregnancy can alter renal function, potentially impacting the accuracy of eGFR measurements. This study aims to evaluate the effectiveness of various eGFR equations in pregnant women, to identify the optimal equation for managing renal health during pregnancy and thereby reduce associated complications.

Methods:

The study employed a cross-sectional design, involving 100 pregnant women recruited from Can Tho City Obstetrics and Gynecology Hospital in Vietnam between December 2021 and August 2022. Eligible participants included those with a gestational age of 20 weeks or more who voluntarily participated and complied with exclusion criteria. The primary reference standard chosen for this study was the 24-hour creatinine clearance (24h-CrCl), against which five renal function estimation equations were compared: MDRD, CKD-EPI SCysC 2012, Nanra, CKD-EPI SCr 2021, and CKD-EPI SCr-SCysC 2021. The equations were evaluated based on bias, P30 accuracy, interquartile range (IQR), and Pearson's correlation coefficient (r).

Results:

The study included 100 pregnant women, with a mean age of 32.4 ± 6.4 years. The average creatinine clearance was 153.0 mL/min/1.73m². Among the evaluated equations, the Nanra equation demonstrated the best performance. Specifically, the Nanra equation showed a bias of 12.80 mL/min/1.73m², a P30 accuracy of 63%, IQR of 61.66 mL/min/1.73m², and a Pearson’s correlation coefficient (r) of 0.442.

Conclusions:

Our findings indicate that the Nanra equation demonstrates superior accuracy in calculating eGFR among pregnant women, compared to other equations. Nevertheless, it is important to note the inherent constraints of this study, including a relatively modest sample size and the fact that the gold standard method for measuring GFR cannot be performed on pregnant women, necessitating the use of 24h-CrCl as a reference standard. To confirm these initial findings and determine their applicability to a wider population, more extensive research and rigorous validation are essential.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.