Use of CKD-EPI creatinine equation led to fewer cases in Korean, US Asian patients
Click Here to Manage Email Alerts
Key takeaways:
- Chronic kidney disease prevalence measured by the 2021 creatinine equation was 9.75% in Korean patients.
- CKD prevalence measured by the 2021 equation was 11.60% in U.S. Asian patients.
Use of the 2021 Chronic Kidney Disease-Epidemiology Collaboration creatinine equation led to identifying a lower rate of CKD among Korean and U.S. Asian populations, a published study shows.
The equation resulted in a reclassification of patients initially thought to have CKD stage G3 or higher.
“The prevalence of CKD in Asian nations, as well as etiologies of CKD, widely varies by region,” Jimin Hwang, MD, MPH, of the University of Texas Southwestern Medical Center and Johns Hopkins Bloomberg School of Public Health, wrote with colleagues. “Within the U.S., Asian Americans are reported to have higher prevalence of elevated albuminuria and lower probability of reduction in eGFR compared to the Caucasian population, possibly blunting the effects of changes in GFR estimating algorithms.”
The Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) creatinine equation updated the eGFR calculation by removing the race coefficient. It made race binary, using Black and “non-Black” groups, according to the study, and involved few Asian participants.
Hwang and colleagues conducted an observational study using national surveys to understand the difference between the 2021 and 2009 equations on estimates in two Asian populations.
The study included patients from the 2019 Korea National Health and Nutrition Survey and patients self-reported as Asian from the 2011 to 2020 U.S. National Health and Nutrition Survey. Main outcomes were CKD prevalence, defined as eGFR less than 60 mL/min/1.73 m2 or urine albumin-to-creatinine ratio equal to or greater than 30 mg/g.
CKD prevalence measured by the 2021 CKD-EPI equation was 9.75% in Korean patients and 11.60% in U.S. Asian patients, according to the study. This prevalence was slightly lower than that found with the estimated 2009 equation, with a decrease of 0.63% in Korean patients and 0.84% in U.S. Asian patients. Researchers also found a significant percentage of patients originally classified with CKD G3 through G5 by the 2009 equation were reclassified as not having CKD G3 through G5 with the 2021 equation; 32.8% of Korean patients and 30.2% of U.S. Asian patients had this reclassification.
“In conclusion, the introduction of the 2021 equation resulted in decreased CKD prevalence in Korean and U.S. Asian population, with a larger decrease in the older population,” the researchers wrote. “Almost one-third of individuals with CKD G3 [to] 5 by the 2009 equation were reclassified as not having CKD G3 [to] 5 by the 2021 equation, and the majority of them were individuals aged 65 [years] or older.
“Further studies for bias assessment and accuracy are needed to better understand the effect of new equation,” the researchers wrote.
Collapse
Click Here to Manage Email Alerts