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

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 m². Around 60 and 20 mL/min/1.73 m², 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.