Abstract
This cross-sectional study investigates US population changes in chronic kidney disease (CKD) G stage and 4 CKD-related complications, comparing the 2021 equation for estimating glomerular filtration rate with the 2009 equation, which included a race coefficient.
Highlights
Estimating glomerular filtration rate from serum creatinine is common in medicine
An estimated 18.1 million adults had an Estimating glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m2 using either equation
An estimated 5.5 million adults were reclassified in G stage with the 2021 equation: 1.0 million into a more severe stage and 4.5 million into a less severe stage
Summary
Estimating glomerular filtration rate (eGFR) from serum creatinine is common in medicine. The 2009 Chronic Kidney Disease–Epidemiology Collaboration (CKD-EPI) equation uses age, sex, race (Black vs non-Black), and creatinine level. Concerns were raised that the use of race in estimating GFR could contribute to care inequities.[1] CKD-EPI recently derived an equation for eGFR from serum creatinine level without a race coefficient, the adoption of which is recommended by a national task force.[2,3] Validity of CKD staging using eGFR thresholds (ie, CKD G stages) is in part supported by CKD-related complications at more severe stages.[4] Changes in G stage with the new equation could affect diagnosis and treatment for many persons. We investigated US population changes in CKD G stage and in 4 CKD-related complications, comparing the race-free serum creatinine–based 2021 CKD-EPI equation with the 2009 equation
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