National Kidney Foundation consensus: Race-free eGFR may optimize decision-making
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Key takeaways:
- The paper provides a race-free equation to estimate kidney filtration in adults with stable kidney function.
- It shows how adjusting eGFR results for body surface may improve decision results.
The National Kidney Foundation published a consensus document that advocates transition to race-free eGFR equations in health-related decision-making.
Crafted by an interdisciplinary group, the document promotes agreement among clinicians and patients “that kidney function assessed by eGFR should be used to optimize medication-related decision-making across the [United States],” Joseph Vassalotti, MD, National Kidney Foundation (NKF) chief medical officer, said in a press release.
As part of a dedicated Workgroup for Implementation of Race-Free eGFR-Based Medication-Related Decisions, the NKF recommends researchers and providers switch from the Cockcroft-Gault creatinine clearance equation to the 2021 Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) method.
The consensus paper aligns with recommendations from the NKF and American Society of Nephrology 2021 Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases, which promote race-free CKD-EPI eGFR in health and medicine-related choices.
Shifting to the newer race-free model would enhance accuracy in assessing kidney function and prescribing medicine, according to the document. Specifically, the transition would:
- provide evidence and expert consensus to estimate kidney filtration for adults with stable kidney function using race-free eGFR; and
- show how adjusting eGFR results for body surface area when it is higher or lower than 1.73 m2 may improve results for medication-related decisions.
Now may be time to transition to race-free equations, according to the document, because recent pharmacokinetic studies favor eGFR to evaluate kidney function for new medicines.
“Concerted efforts to accelerate the transition from the Cockcroft-Gault formula to the more representative race-free 2021 CKD-EPI eGFR will ensure more accurate and consistent medication-related decisions among the diverse American population with low kidney function,” Wendy St. Peter, PharmD, NKF workgroup co-chair, said in the release.
The consensus marks another step in a multipronged approach to raise awareness and transform practice regarding eGFR use. The NKF said it plans to collaborate with various organizations, including clinicians and patients, to move its efforts ahead.
“Moving Forward from Cockcroft and Gault Creatinine Clearance to Race-Free Estimated Glomerular Filtration Rate to Improve Medication-Related Decision-Making in Adults Across Healthcare Settings” appears in American Journal of Health-System Pharmacy.
Reference:
NKF Workgroup for Implementation of Race-Free eGFR-Based Medication-Related Decisions publishes consensus on transition from Cockcroft Gault creatinine clearance to race-free eGFR equations. https://www.kidney.org/press-room/nkf-workgroup-implementation-race-free-egfr-based-medication-related-decisions-publishes. Published Nov. 20, 2024. Accessed Jan. 8, 2025.
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