Impact of race-based and race-free CKD-EPI equations on estimated glomerular filtration rate in a multicenter retrospective cohort of autosomal dominant polycystic kidney disease
Turkish Journal of Medical Sciences, cilt.56, sa.3, ss.787-793, 2026 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 56 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.55730/1300-0144.6212
- Dergi Adı: Turkish Journal of Medical Sciences
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.787-793
- Anahtar Kelimeler: Autosomal dominant polycystic kidney disease, chronic kidney disease staging, CKD-EPI equation, estimated glomerular filtration rate, race-free equation
- Bursa Uludağ Üniversitesi Adresli: Evet
Özet
Background/aim: The 2021 revision of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, which eliminates race-based coefficients, may significantly influence disease staging and treatment in autosomal dominant polycystic kidney disease (ADPKD). This study was designed to evaluate the impact of the 2021 race-free CKD-EPI equation on estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) staging in a multi-ethnic ADPKD population. Materials and methods: In this multicenter, retrospective cohort study, 597 ADPKD patients were evaluated, including 515 self-identified as Caucasian and 82 as African-American. eGFR values at baseline and final follow-up were calculated using both the 2009 and 2021 CKD-EPI equations. Changes in CKD staging and clinical implications were assessed based on the race-free equation. Results: Among Caucasian patients, the median baseline eGFR increased from 85.0 to 88.6 mL/min/1.73 m² and the final eGFR from 63.1 to 66.1 mL/min/1.73 m² using the 2021 equation (p < 0.001). In contrast, the 2021 equation resulted in decreased eGFR among African-American patients, from 89.3 to 80.3 mL/min/1.73 m² at baseline and from 46.8 to 42.6 mL/min/1.73 m² at final follow-up (p < 0.001). A total of 6.7% of Caucasian patients were downstaged initially and 5.7% at final follow-up. Conversely, 2.3% of African-American patients were upstaged at baseline and 1.8% at final follow-up. Conclusion: The 2021 CKD-EPI equation significantly alters eGFR estimation and CKD staging compared to the 2009 version, with varying impacts across ethnic groups. These findings highlight the importance of careful interpretation of eGFR and individualized clinical decision-making in patients with ADPKD.