Calculating estimated glomerular filtration rate without the race correction factor: Observations at a large academic medical system

肾功能 医学 肌酐 泌尿科 人口 内科学 肾脏疾病 肾病科 种族(生物学) 统计 生物 植物 环境卫生
作者
Junyan Shi,Edwin G. Lindo,Geoffrey S. Baird,Bessie A. Young,Michael J. Ryan,J. Ashley Jefferson,Rajnish Mehrotra,Patrick C. Mathias,Andrew N. Hoofnagle
出处
期刊:Clinica Chimica Acta [Elsevier BV]
卷期号:520: 16-22 被引量:7
标识
DOI:10.1016/j.cca.2021.05.022
摘要

• We removed the race correction factor from eGFR while moving from MDRD to CKD-EPI. • Reclassification rates were determined for our patient population. • Distributions of eGFR without race were similar in Black and non-Black patients. Creatinine-based MDRD and CKD-EPI equations include a race correction factor, which results in higher eGFR in Black patients. We evaluated the impact on our patient population upon adoption of the CKD-EPI equation and the removal of the race correction factor from the equation. Retrospective analysis of blood creatinine results and respective eGFR values calculated by the MDRD or CKD-EPI equation without the race correction factor (CKD-EPI NoRace ) in a large academic medical system over a 20.5-month period. In our population, when changing from MDRD to CKD-EPI NoRace , we observed that 3.5% of all patients were reclassified to categorically have worse kidney function. However, we also observed fewer patients overall with eGFR below 60 mL/min/1.73 m 2 . Around 60 and 20 mL/min/1.73 m 2 , 2.96% and 0.16% of all patients > 65 years of age were reclassified, as were 4.29% and 0.03% of all Black patients, respectively. When calculated with CKD-EPI NoRace , median eGFR was not meaningfully different between Black and non-Black patients (p = 0.02). Changing from MDRD to CKD-EPI NoRace could lead to a lower referral rate to nephrology. The distributions of creatinine and eGFR calculated with CKD-EPI NoRace were not meaningfully different in Black and non-Black patients.
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