NEW findings offered at UK Kidney Week 2026 from the AIM CKD UK research counsel that generally used creatinine-based equations to estimate glomerular filtration fee (eGFR) might considerably misclassify kidney operate, probably delaying analysis and remedy for persistent kidney illness (CKD), significantly in sure ethnic teams.
The multi-centre evaluation in contrast the efficiency of 5 broadly used eGFR equations towards measured GFR (mGFR) in a big and ethnically various UK cohort.
Considerations Over Creatinine-Primarily based eGFR Equations in Various Populations
Correct kidney operate evaluation is important for diagnosing and staging Continual Kidney Illness. Nonetheless, the reliability of creatinine-based equations has been questioned, significantly in youthful adults and minority populations. The research was designed to deal with these gaps highlighted by Nationwide Institute for Well being and Care Excellence steerage.
Researchers performed a cross-sectional evaluation throughout 11 UK centres together with 15,879 adults who underwent mGFR testing between 2009 and 2022 with a paired serum creatinine measurement. 5 equations have been evaluated: MDRD, CKD-EPI-2009, CKD-EPI-2021, EKFC, and Lund-Malmö Revised (LMR). Efficiency was assessed via bias, precision, 30% accuracy (P30), and settlement with measured GFR, with outcomes stratified by ethnicity.
Total, all equations systematically overestimated measured kidney operate. The LMR equation demonstrated the very best efficiency, exhibiting the bottom bias (1.4 mL/min/1.73m²) and highest accuracy (P30 86%). The EKFC equation additionally carried out effectively (P30 83.6%). In distinction, accuracy was considerably decrease for CKD-EPI-2009 (76.0%), MDRD (73.5%), and CKD-EPI-2021 (70.1%).
Efficiency additionally various considerably throughout ethnic teams. In White individuals, LMR and EKFC achieved P30 values of 87% and 85%, respectively, in contrast with 77% utilizing CKD-EPI-2009 and 71% utilizing CKD-EPI-2021. Amongst Black individuals, EKFC and LMR once more carried out finest, whereas CKD-EPI-2021 and MDRD remained under beneficial thresholds. South Asian individuals confirmed the poorest accuracy general, with CKD-EPI-2021 overestimating kidney operate by virtually 18 mL/min/1.73m² and reaching solely 58% accuracy.
Lowered efficiency was additionally noticed in youthful adults below 25 years, in addition to people with low physique mass index or hypoalbuminaemia, highlighting limitations of creatinine as a biomarker in these teams.
Bettering Fairness in Kidney Illness Analysis and Administration
Importantly, equation alternative affected medical classification and remedy eligibility. CKD-EPI equations appropriately staged CKD in solely 55–60% of instances in contrast with 65% utilizing LMR. Variations additionally influenced eligibility for therapies resembling Dapagliflozin, probably delaying remedy in as much as half of sufferers relying on the equation used.
The researchers conclude that continued reliance on CKD-EPI equations might underestimate CKD severity and create inequities in care. Adoption of LMR or EKFC equations in UK medical apply might enhance diagnostic accuracy and remedy entry throughout various populations.
Reference
Gama R et al. Assessing eGFR vs measured GFR in a various UK multi-centre cohort (The AIM CKD UK research): Time for a change? UK Kidney Week, 10-12 March, 2026.
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