Calculating estimated glomerular filtration rate without the race correction factor: Observations at a large academic medical system
| Autor: | Junyan Shi, Bessie A. Young, Michael J. Ryan, J. Ashley Jefferson, Patrick C. Mathias, Edwin G. Lindo, Rajnish Mehrotra, Geoffrey S. Baird, Andrew N. Hoofnagle |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Nephrology medicine.medical_specialty Blood creatinine Clinical Biochemistry Population Urology Renal function urologic and male genital diseases Biochemistry Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Retrospective analysis Humans Renal Insufficiency Chronic education Retrospective Studies Creatinine education.field_of_study business.industry Biochemistry (medical) General Medicine female genital diseases and pregnancy complications Patient population 030104 developmental biology chemistry 030220 oncology & carcinogenesis business Glomerular Filtration Rate |
| Zdroj: | Clin Chim Acta |
| ISSN: | 0009-8981 |
| DOI: | 10.1016/j.cca.2021.05.022 |
| Popis: | Background and aims 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. Materials and methods Retrospective analysis of blood creatinine results and respective eGFR values calculated by the MDRD or CKD-EPI equation without the race correction factor (CKD-EPINoRace) in a large academic medical system over a 20.5-month period. Results In our population, when changing from MDRD to CKD-EPINoRace, 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-EPINoRace, median eGFR was not meaningfully different between Black and non-Black patients (p = 0.02). Conclusions Changing from MDRD to CKD-EPINoRace could lead to a lower referral rate to nephrology. The distributions of creatinine and eGFR calculated with CKD-EPINoRace were not meaningfully different in Black and non-Black patients. |
| Databáze: | OpenAIRE |
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