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CKD-EPI for GFR
CKD-EPI for GFR
Provides a more precise estimate of kidney function for staging and managing CKD.

CKD-EPI for GFR
CKD-EPI for GFR
Provides a more precise estimate of kidney function for staging and managing CKD.
Instructions
The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation estimates glomerular filtration rate (eGFR) based on serum creatinine, age, sex, and race. Clinicians enter patient-specific values, and the tool outputs an estimated GFR, helping assess kidney function and stage chronic kidney disease (CKD). It is more accurate than the MDRD equation, especially at higher GFR levels.
Overview
When to use
Why use
Evidences
Interpretation
CKD‑EPI publishes eGFR formulas using serum creatinine (eGFRcr), cystatin C (eGFRcys), and a combined creatinine‑cystatin C equation (eGFRcr‑cys), calibrated to IDMS‑traceable assays and indexed to 1.73 m2 BSA. The 2009 eGFRcr included a race coefficient; the 2021 equation removes race and refits parameters: eGFR = 142 × min(Scr/k,1)α × max(Scr/k,1)−1.200 × 0.9938Age × 1.012 if female, improving equity and remaining sufficiently accurate for most routine use.
https://www.kidney.org/sites/default/files/441-8491_2202_faqs_aboutgfr_v5.pdf
2021 race‑free performance: Relative to 2009, the 2021 eGFRcr yields lower values in people who previously would have been assigned “Black race” and higher values in others; while overall accuracy (P30) may be marginally lower than 2009, it avoids race use and is recommended for universal adoption.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9123604/
The 2021 CKD‑EPI creatinine‑cystatin C equation reduces bias and improves P30 vs creatinine‑only and is encouraged when decisions hinge on precise GFR near therapeutic thresholds.
https://www.cap.org/member-resources/articles/cap-recommendations-for-adoption-of-new-egfr-equation
National groups recommend immediate use of the 2021 CKD‑EPI creatinine equation and increased access to cystatin C testing; calculators from NIDDK and professional societies now default to race‑free formulas.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10797164/
Overview
When to use
Why use
Evidences
Glomerular filtration rate (GFR) is the best overall indicator of kidney function, reflecting how efficiently the kidneys filter waste and maintain fluid, electrolyte, and metabolic balance. Direct measurement of GFR using clearance techniques (e.g., inulin clearance) is accurate but impractical for routine clinical care. Therefore, estimating GFR from serum creatinine levels has become the standard approach in nephrology.
The CKD-EPI equation was developed in 2009 to improve the accuracy of GFR estimation, particularly in patients with near-normal or mildly reduced kidney function. Compared with the older MDRD formula, CKD-EPI reduces bias and avoids underestimation of GFR in healthier populations, making it more reliable across a broad spectrum of kidney function.
This equation incorporates serum creatinine, age, sex, and race (Black vs non-Black in the original version). However, more recent recommendations encourage use of a race-neutral CKD-EPI equation to eliminate disparities in kidney disease diagnosis and management.
Overview
When to use
Why use
Evidences
Interpretation
CKD‑EPI publishes eGFR formulas using serum creatinine (eGFRcr), cystatin C (eGFRcys), and a combined creatinine‑cystatin C equation (eGFRcr‑cys), calibrated to IDMS‑traceable assays and indexed to 1.73 m2 BSA. The 2009 eGFRcr included a race coefficient; the 2021 equation removes race and refits parameters: eGFR = 142 × min(Scr/k,1)α × max(Scr/k,1)−1.200 × 0.9938Age × 1.012 if female, improving equity and remaining sufficiently accurate for most routine use.
https://www.kidney.org/sites/default/files/441-8491_2202_faqs_aboutgfr_v5.pdf
2021 race‑free performance: Relative to 2009, the 2021 eGFRcr yields lower values in people who previously would have been assigned “Black race” and higher values in others; while overall accuracy (P30) may be marginally lower than 2009, it avoids race use and is recommended for universal adoption.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9123604/
The 2021 CKD‑EPI creatinine‑cystatin C equation reduces bias and improves P30 vs creatinine‑only and is encouraged when decisions hinge on precise GFR near therapeutic thresholds.
https://www.cap.org/member-resources/articles/cap-recommendations-for-adoption-of-new-egfr-equation
National groups recommend immediate use of the 2021 CKD‑EPI creatinine equation and increased access to cystatin C testing; calculators from NIDDK and professional societies now default to race‑free formulas.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10797164/
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