ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2023
Removing race from the CKD-EPI equation and its impact on prognosis in a predominantly White European population.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
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51 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Association of glomerular hyperfiltration with mortality in stroke: an analysis using pooled individual patient data.European stroke journal · 2026Pooled it
- [Diabetic kidney disease (Update 2026) : Guidelines in a collaboration of the Austrian Diabetes Association and the Austrian Society of Nephrology].Wiener klinische Wochenschrift · 2026Guideline
- Association of Enlarged Perivascular Spaces and Total Small Vessel Disease Burden With Kidney Function.Neurology · 2026Article
- Retrospective and comparative assessment of MDRD, CKD-EPI, and EKFC equations for estimating glomerular filtration rate in a clinically heterogeneous hospital population.International urology and nephrology · 2026Article
- A Microsimulation-Based Approach for Mitigating Societal Bias in Chronic Kidney Disease Data.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- Artificial intelligence in chronic kidney disease: Early detection, risk prediction, and personalized treatment strategies.World journal of nephrology · 2026Review
- Which equation and which biomarker should be used in the Kidney Failure Risk Equation? A comparative analysis in the CKD-REIN cohort.Clinical kidney journal · 2026Article
- Impact of Adopting the Race/Ethnicity-Free 2021 CKD-EPI Equation on Cardiovascular Risk Stratification in a Multiethnic European Population: Results from the HELIUS Study.Global heart · 2026Article
- Impact of race-based and race-free CKD-EPI equations on estimated glomerular filtration rate in a multicenter retrospective cohort of autosomal dominant polycystic kidney disease.Turkish journal of medical sciences · 2026Article
- A microsimulation-based framework for mitigating societal bias in primary care data.medRxiv : the preprint server for health sciences · 2025Article
- Impact of Creatinine-eGFR Equations on Chronic Kidney Disease Stratification in a Ghanaian Tertiary Care Setting.EJIFCC · 2025Article
- Accuracy of glomerular filtration rate estimates among patients with cancer.British journal of cancer · 2025Observational
- When equations disagree: the impact of creatinine-based eGFR in CKD diagnosis and reclassification.BMC nephrology · 2025Article
- Albuminuria is associated with increased risk of dementia, independent of eGFR: The SCREAM project.Journal of internal medicine · 2025Article
- Performance of Creatinine and Cystatin C-Based Equations to Estimate Glomerular Filtration Rate Among Patients With Heart Failure.Circulation. Heart failure · 2025Article
- Comparison of estimated glomerular filtration rate equations on prediction of mortality, kidney failure and acute kidney injury.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Article
- Performance evaluation of Chronic Kidney Disease Epidemiology Collaboration equations for estimated glomerular filtration rate compared to inulin clearance in Koreans.Kidney research and clinical practice · 2025Article
- Rethinking Chronic Kidney Disease Epidemiology Collaboration equations in the Korean population: from race-based to region-based estimation.Kidney research and clinical practice · 2025Article
- Associations of serum Klotho with diabetic kidney disease prevalence and mortality: insights from a nationally representative U.S. cohort.Diabetology & metabolic syndrome · 2025Article
- Quantitative Assessment of the Effect of Chronic Kidney Disease on Plasma P-Tau217 Concentrations.Neurology · 2025Observational
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Authors and funding
11 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundWhile American nephrology societies recommend using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (eGFR) equation without a Black race coefficient, it is unknown how this would impact disease distribution, prognosis and kidney failure risk prediction in predominantly White non-US populations.
methodsWe studied 1.6 million Stockholm adults with serum/plasma creatinine measurements between 2007 and 2019. We calculated changes in eGFR and reclassification across KDIGO GFR categories when changing from the 2009 to 2021 CKD-EPI equation; estimated associations between eGFR and the clinical outcomes kidney failure with replacement therapy (KFRT), (cardiovascular) mortality and major adverse cardiovascular events using Cox regression; and investigated prognostic accuracy (discrimination and calibration) of both equations within the Kidney Failure Risk Equation.
resultsCompared with the 2009 equation, the 2021 equation yielded a higher eGFR by a median [interquartile range (IQR)] of 3.9 (2.9-4.8) mL/min/1.73 m2, which was larger at older age and for men. Consequently, 9.9% of the total population and 36.2% of the population with CKD G3a-G5 was reclassified to a higher eGFR category. Reclassified individuals exhibited a lower risk of KFRT, but higher risks of all-cause/cardiovascular death and major adverse cardiovascular events, compared with non-reclassified participants of similar eGFR. eGFR by both equations strongly predicted study outcomes, with equal discrimination and calibration for the Kidney Failure Risk Equation.
conclusionsImplementing the 2021 CKD-EPI equation in predominantly White European populations would raise eGFR by a modest amount (larger at older age and in men) and shift a major proportion of CKD patients to a higher eGFR category. eGFR by both equations strongly predicted outcomes.
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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.