Original InvestigationPathogenesis and Treatment of Kidney DiseaseCalibration of Serum Creatinine in the National Health and Nutrition Examination Surveys (NHANES) 1988-1994, 1999-2004
Section snippets
NHANES
The NHANES are ongoing cross-sectional surveys of the civilian noninstitutionalized population of the United States. These surveys are conducted by the National Center for Health Statistics (NCHS) and designed to assess the health and nutritional status of adults and children in the United States. Detailed in-person interviews, physical examinations, and serum samples are obtained from thousands of participants in each survey.4, 5
The original serum creatinine assays in the NHANES III
Results
Of 800 sampled specimens, 781 were available in sufficient quantities for measurement. We further excluded 11 outliers from the analyses by using our prespecified criteria. The final sample sizes by survey were 190 in NHANES III, 196 in 1999-2000, 194 in 2001-2002, and 190 in 2003-2004.
Overall agreement between the original NHANES serum creatinine measurements and measurements done by CCRL using the Roche enzymatic method was high, indicated by Pearson correlation coefficients (Table 1). Mean
Discussion
The magnitude of the difference in serum creatinine measurements in NHANES III and 1999-2000 from gold-standard methods would result in large differences in estimates of GFR regardless of the estimating equation used. Thus, correction of original serum creatinine values for NHANES III and 1999-2000 is essential for the appropriate estimation of kidney function in these studies.
We previously directly compared serum creatinine measurements from NHANES III performed at the Coulston Laboratory with
Acknowledgements
The authors thank Dr Geraldine McQuillan (NCHS) for assistance.
Support: This work was supported by grants from the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK076595 to Dr Selvin, UO1 DK 053869 to Dr Levey, UO1 DK 067651 and R21DK67651 to Dr Coresh). Dr Coresh was also supported by the National Center for Research Resources (GCRC grant RR00722).
Financial Disclosure: None.
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Originally published online as doi:10.1053/j.ajkd.2007.08.020 on November 5, 2007.
Because an author of this manuscript is an editor for AJKD, the peer-review and decision-making processes were handled entirely by an outside editor, Bryan Becker, MD, University of Wisconsin, who served as Acting Editor-in-Chief. Details of the journal’s procedures for potential editor conflicts are given in the Editorial Policies section of the AJKD website.