The CKD-EPI 2021 Equation and Other Creatinine-Based Race-Independent eGFR Equations in Chronic Kidney Disease Diagnosis and Staging
Background
Recent debate on the race correction factor in creatinine-based estimated glomerular filtration rate (eGFR) has led to the development of a new race-independent equation (Chronic Kidney Disease Epidemiology Collaboration, CKD-EPI_2021). Previously, some institutions have already modified the early version of the CKD-EPI or Modification of Diet in Renal Disease (MDRD) equations by removing the race factors (CKD-EPI_2009_non-Black (NB), MDRD_NB) for Black populations although this approach remains controversial.
Methods
In this study, the CKD-EPI_2009_NB, MDRD_NB, and European Kidney Function Consortium (EKFC) equations were compared directly with the CKD-EPI_2021 equation in eGFR calculation, chronic kidney disease (CKD) diagnosis, and staging in a local population.
Results
These 3 previous methods underestimated eGFR compared to CKD-EPI_2021 for eGFR < 90 mL/min/1.73 m2 but overestimated eGFR at the high end (>120 mL/min/1.73 m2). Around the CKD diagnosis cutoff (60 mL/min/1.73 m2), both MDRD_NB and EFKC equations resulted in an increase in CKD cases compared to CKD-EPI_2021. CKD-EPI_2009_NB demonstrated a similar trend although the difference was not statistically significant. In a population with low eGFR (<60 mL/min/1.73 m2), the EKFC equation showed a CKD staging pattern significantly different from that by CKD-EPI_2021, but all 3 previous methods resulted in a similar number of end-stage renal failure cases. In general, the EKFC equation demonstrated a weaker agreement in eGFR calculation and concordance in classification with the CKD-EPI_2021 equation than MDRD_NB and CKD-EPI_2009_NB.
Conclusions
Our study provides a direct visual comparison to demonstrate the potential clinical impact between 3 previously used race-independent methods and the CKD-EPI_2021 equation and aids the communication with healthcare providers during the implementation of this new equation.
No keywords indexed for this article. Browse by subject →
Andrew S. Levey, Josef Coresh, Hocine Tighiouart et al.
Lesley A. Inker, Nwamaka D. Eneanya, Josef Coresh et al.
Hans Pottel, Jonas Björk, Marie Courbebaisse et al.
Andrew S. Levey, Lesley A. Stevens, Christopher H. Schmid et al.
Andrew S. Levey, Josef Coresh, Tom Greene et al.
- Published
- Aug 03, 2023
- Vol/Issue
- 8(5)
- Pages
- 952-961
- License
- View
You May Also Like
Lisa Ford, Adam D Kennedy · 2020
163 citations
Tatjana Ammer, André Schützenmeister · 2023
38 citations
Melissa Yuwono Tjota, Jeremy P Segal · 2024
33 citations
Clare Fiala, Eleftherios P Diamandis · 2020
25 citations
Katie L Thoren, Samuel I McCash · 2021
19 citations