Evidence map›Paper›PMID 39885391›Full record

Observational studyBMC nephrology2025

Enhancing individual glomerular filtration rate assessment: can we trust the equation? Development and validation of machine learning models to assess the trustworthiness of estimated GFR compared to measured GFR.

Antoine Lanot, Anna Akesson, Felipe Kenji Nakano, Celine Vens, Jonas Björk, Ulf Nyman, Anders Grubb, Per-Ola Sundin, Björn O Eriksen, Toralf Melsom and 21 more

Abstract readObservational StudyValidation StudyComparative Study
In one paragraph

Observational study in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Calibration and prediction of results after failed injection in SPECT renal dynamic imaging.American journal of nuclear medicine and molecular imaging · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Antoine LanotNormandie Univ, UNICAEN, CHU de Caen Normandie, Néphrologie, Caen, France. antoine.lanot@gadz.org.
Anna AkessonSkane University Hospital, Clinical Studies Sweden Forum South, Remissgatan 4, Lund, 22185, Sweden.
Felipe Kenji NakanoDepartment of Public Health and Primary Care, KU Leuven, Campus Kulak, Kortrijk, Belgium.
Celine VensDepartment of Public Health and Primary Care, KU Leuven, Campus Kulak, Kortrijk, Belgium.
Jonas BjörkLund University, Box 117, 221 00, Lund, Sweden.
Ulf Nyman, Östra Vallgatan 41, 223 61, Lund, Sweden.
Anders GrubbDepartment of Clinical Chemistry and Pharmacology, Laboratory Lund University, Lund, 22185, Sweden.
Per-Ola SundinKarla Healthcare Centre, Faculty of Medicine and Health, Örebro University, Örebro, 701 85, Sweden.
Björn O EriksenUniversity Hospital of North Norway (UNN), 9038, Breivika, Troms, Norway.
Toralf MelsomUniversity Hospital of North Norway (UNN), 9038, Breivika, Troms, Norway.
Andrew D RuleDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Ulla BergDepartment of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Karolinska University. Hospital Huddinge, 14186, Stockholm, Sweden.
Karin LittmannDepartment of Medicine Huddinge, Karolinska Institutet, C2:91 Karolinska University Hospital, Huddinge, SE-141 52, Sweden.
Kajsa Åsling-MonemiBarnnjursektionen K 88, Astrid Lindgrens Barnsjukhus, Karolinska University Hospital, Stockholm, 141 86, Sweden.
Magnus HanssonDepartment of Clinical Chemistry, C1:74 Huddinge, Karolinska University Hospital, Stockholm, SE-141 86, Sweden.
Anders LarssonClinical Chemistry and Pharmacology, Entrance 61, 2Nd Floor, Akademiska Hospital, 751 85, Uppsala, Sweden.
Marie CourbebaisseService de Physiologie-Explorations, Fonctionnelles Renales Hopital Europeen Georges Pompidou, 20 Rue Leblanc, Paris, 75015, France.
Laurence DubourgExploration Fonctionnelle Renale Pavillon P, Hopital Edouard Herriot, 5 Place d'Arsonval, 69437, Lyon, Cedex 03, France.
Lionel CouziCHU de Bordeaux, Nephrologie-Transplantation-Dialyse, Hopital Pellegrin, Universite de Bordeaux, Place Amelie Raba Leon, Bordeaux, 33076, France.
Francois GaillardRenal Transplantation Department, Assistance Publique-Hopitaux de Paris (AP-HP), Hopital Bichat, 46 Rue Henri Huchard, Paris, 75018, France.
Cyril GarrousteDepartment of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
Lola JacquemontService de Nephrologie Et Immunologie Clinique, CHU de Nantes, 30 Boulevard Jean Monnet, 44093, Nantes, Cedex 1, France.
Nassim KamarDepartment of Nephrology and Organ Transplantation, CHU Rangueil, 1 Avenue J.Poulhes, TSA 50032, 31059, Toulouse, Cedex 9, France.
Christophe LegendreTransplantation Renale, Hopital Necker, 145 Rue de Sevres, Paris, 75015, France.
Lionel RostaingService de Nephrologie, Hemodialyse, Aphereses Et Transplantation Renale, Hopital Michallon, Centre Hospitalier Universitaire Grenoble-Alpes, Boulevard de La Chantourne, La Tronche, 38700, France.
Natalie EbertInstitute of Public Health, Charité. Universitätsmedizin Berlin, Luisenstrasse 57, Berlin, 10117, Germany.
Elke SchaeffnerInstitute of Public Health, Charité. Universitätsmedizin Berlin, Luisenstrasse 57, Berlin, 10117, Germany.
Arend BökenkampAmsterdam UMC, Vrije Universiteit, De Boelelaan 1112, Amsterdam, 1081 HV, the Netherlands.
Christophe MariatService de Nephrologie, Dialyse Et Transplantation Renale, Hopital Nord, CHU de Saint-Etienne, 25 Boulevard Pasteur, 42055, Saint-Etienne, Cedex 2, France.
Hans Pottel *Department of Public Health and Primary Care, KU Leuven, Campus Kulak, Kortrijk, Belgium.
Pierre Delanaye *Department of Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCreatinine-based estimated glomerular filtration rate (eGFR) equations are widely used in clinical practice but exhibit inherent limitations. On the other side, measuring GFR is time consuming and not available in routine clinical practice. We developed and validated machine learning models to assess the trustworthiness (i.e. the ability of equations to estimate measured GFR (mGFR) within 10%, 20% or 30%) of the European Kidney Function Consortium (EKFC) equation at the individual level.

methodsThis observational study used data from European and US cohorts, comprising 22,343 participants of all ages with available mGFR results. Four machine learning and two traditional logistic regression models were trained on a cohort of 9,202 participants to predict the likelihood of the EKFC creatinine-derived eGFR falling within 30% (p30), 20% (p20) or 10% (p10) of the mGFR value. The algorithms were internally and then externally validated on cohorts of respectively 3,034 and 10,107 participants. The predictors included in the models were creatinine, age, sex, height, weight, and EKFC.

resultsThe random forest model was the most robust model. In the external validation cohort, the model achieved an area under the curve of 0.675 (95%CI 0.660;0.690) and an accuracy of 0.716 (95%CI 0.707;0.725) for the P30 criterion. Sensitivity was 0.756 (95%CI 0.747;0.765) and specificity was 0.485 (95%CI 0.460; 0.511) at the 80% probability level that EKFC falls within 30% of mGFR. At the population level, the PPV of this machine learning model was 89.5%, higher than the EKFC P30 of 85.2%. A free web-application was developed to allow the physician to assess the trustworthiness of EKFC at the individual level.

conclusionsA strategy using machine learning model marginally improves the trustworthiness of GFR estimation at the population level. An additional value of this approach lies in its ability to provide assessments at the individual level.

Indexed as

Glomerular Filtration RateKidney Function TestsMachine LearningAdultAgedCohort StudiesCreatinineFemaleHumansMaleMiddle AgedCreatinineChronic kidney diseaseCreatinineGlomerular filtration rateMachine learningRandom forest

Identifiers

PMID39885391
PMCPMC11780799

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.