{"doi":"10.1093/ndt/gfac197","title":"Removing race from the CKD-EPI equation and its impact on prognosis in a predominantly White European population","abstract":"BACKGROUND: While 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. METHODS: We 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. RESULTS: Compared 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. CONCLUSIONS: Implementing 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.","journal":"Nephrology Dialysis Transplantation","year":2022,"id":236230,"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":71,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7063,"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":23021,"name":"Josef Coresh","orcid":"0000-0002-4598-0669","position":1,"is_corresponding":false},{"id":73169,"name":"Morgan E. Grams","orcid":"0000-0002-4430-6023","position":2,"is_corresponding":false},{"id":856090,"name":"Catherine M. Clase","orcid":"0000-0002-4538-5958","position":3,"is_corresponding":false},{"id":856091,"name":"Carl‐Gustaf Elinder","orcid":"0009-0001-5114-347X","position":4,"is_corresponding":false},{"id":268198,"name":"Julie M. Paik","orcid":"0000-0002-1315-5445","position":5,"is_corresponding":false},{"id":856092,"name":"Chava L. Ramspek","orcid":"0000-0002-7883-5927","position":6,"is_corresponding":false},{"id":19370,"name":"Lesley A. Inker","orcid":"0000-0003-2820-9482","position":7,"is_corresponding":false},{"id":58425,"name":"Andrew S. Levey","orcid":"0000-0003-1491-501X","position":8,"is_corresponding":false},{"id":856093,"name":"Friedo W. Dekker","orcid":"0000-0002-2433-2494","position":9,"is_corresponding":false},{"id":19388,"name":"Juan Jesús Carrero","orcid":"0000-0003-4763-2024","position":10,"is_corresponding":false},{"id":856089,"name":"Edouard L. Fu","orcid":"0000-0002-9698-6825","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T00:21:58.728756Z","pmid":"35689668","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":[]}