{"doi":"10.1093/clinchem/hvab282","title":"Clinical Impact of the Refit CKD-EPI 2021 Creatinine-Based eGFR Equation","abstract":"BACKGROUND: The National Kidney Foundation recently endorsed the refit Chronic Kidney Disease Collaboration (CKD-EPI) equation for estimated glomerular filtration rate (eGFR) using creatinine, age and sex [2021 eGFRCr(AS)] without a coefficient for race. We evaluated the impact of adopting the 2021 eGFRCr(AS) equation or a variation of the 2009 CKD-EPI eGFR equation without race [2009 CKD-EPI eGFRCr(ASR-NB)] compared to the original CKD-EPI eGFR [2009 eGFRCr(ASR)]. METHODS: The studied population included patients with a clinically ordered iothalamate clearance (n = 33 889). Bias was assessed as the difference between measured and estimated GFR, P30 was defined as the percentage of estimates within 30% of measured GFR, and concordance was determined according to relevant clinical thresholds. RESULTS: Among Black patients, the median bias for 2009 eGFRCr(ASR), 2009 eGFRCr(ASR-NB), and 2021 eGFRCr(AS) was -1.32 mL min-1 (1.73 m2)-1 (95CI -2.46 to -0.26), -8.81 mL min-1 (1.73 m2)-1 (95CI -9.93 to -7.58), and -6.08 mL min-1 (1.73 m2)-1 (95CI -7.18 to -4.92), respectively. The median bias among non-Black patients was -0.15 m min-1 (1.73 m2)-1 (95CI -0.84 to -0.08) for 2021 eGFRcr(AS) compared to -3.09 mL min-1 (1.73 m2)-1 (95CI -3.17 to -3.03) for the 2009 eGFRCr(ASR). P30 and concordance were not significantly different in either racial group. The net reclassification improvement at a measured GFR <20 mL min-1 (1.73 m2)-1 was 6.4% (95CI 0.36 to 12.4) for Black patients and -5.1% (95CI -6.0 to -4.1) for non-Black patients using the 2021 eGFRCr(AS) equation. CONCLUSIONS: Overall, the change in reported eGFR was minimal. However, these changes led to significant reclassification improvements at lower eGFR, which will indirectly improve equitable access to CKD resources.","journal":"Clinical Chemistry","year":2022,"id":234507,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":96,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.939,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":850107,"name":"Ramla N. Kasozi","orcid":"0000-0001-9621-1619","position":1,"is_corresponding":false},{"id":850546,"name":"Timothy S. Larson","orcid":null,"position":2,"is_corresponding":false},{"id":247050,"name":"John C. Lieske","orcid":"0000-0002-0202-5944","position":3,"is_corresponding":false},{"id":850106,"name":"Jeffrey W. Meeusen","orcid":"0000-0002-0784-034X","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-19T00:21:36.529874Z","pmid":"35038721","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}