Elimination of Race in CKD-EPI Equation for eGFR
CompuNet Clinical Laboratories will be eliminating race in the calculation for the estimated glomerular filtration rate (eGFR) based on formal recommendations from both the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN). After careful review of evidence gathered from diverse stakeholders, the NKF-ASN Task Force recommended immediate implementation of the CKD-EPI creatinine equation refit without the race variable in all U.S. laboratories.
The change will take effect on the following dates:
November 1, 2021: For all ambulatory practices/non-hospital provider orders
November 8, 2021: For all Premier Health hospital inpatient orders
Current calculation:
GFR = 141 * min(Scr/κ,1)α * max(Scr/κ, 1)-1.209 * 0.993Age * 1.018 [if female] * 1.159 [if black]
New calculation (eliminates race specific variable):
GFR = 141 * min(Scr/κ,1)α * max(Scr/κ, 1)-1.209 * 0.993Age * 1.018 [if female]
Background:
In response to a national call for reevaluation of the use of race in clinical algorithms, the NKF and ASN established a task force to reassess inclusion of race in the estimation of eGFR in the United States and its implications for diagnosis and management of patients with or at risk, for, kidney diseases. In September 2021, formal recommendations were released by the task force related to how eGFR is calculated using the CKD-EPI equation:
“For U.S. adults (>85% of whom have normal kidney function), we recommend immediate implementation of the CKD-EPI creatinine equation refit without the race variable in all laboratories in the United States because it does not include race in the calculation and reporting, includes diversity in its development, is immediately available to all labs in the U.S., and has acceptable performance characteristics and potential consequences that do not disproportionately affect any one group of individuals” ¹.
Complete Supporting Article:
A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease - American Journal of Kidney Diseases (ajkd.org)
¹ https://www.ajkd.org/article/S0272-63862100828-3/fulltext
Back to the October 2021 issue of Premier Pulse
