Abstract: TH-PO743
The Impact of the New Creatinine-Based GFR Estimating Equation Without Race in Korean and US Asian Populations
Session Information
- Diversity and Equity in Kidney Health - I
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention
Authors
- Hwang, Jimin, Johns Hopkins University Center for Teaching and Learning, Baltimore, Maryland, United States
- Coresh, Josef, Johns Hopkins University Center for Teaching and Learning, Baltimore, Maryland, United States
- Grams, Morgan, Johns Hopkins University Center for Teaching and Learning, Baltimore, Maryland, United States
- Inker, Lesley Ann, Johns Hopkins University Center for Teaching and Learning, Baltimore, Maryland, United States
- Shin, Jung-Im, Johns Hopkins University Center for Teaching and Learning, Baltimore, Maryland, United States
Background
Guidelines recommend the replacement of the 2009 CKD-EPI creatinine equation using age, sex, and race with the 2021 CKD-EPI creatinine equation without race to calculate estimated glomerular filtration rate (eGFR). This study aimed to examine the impact of the new 2021 CKD-EPI creatinine equation on chronic kidney disease (CKD) prevalence estimates in two distinct Asian populations in Korea and the US.
Methods
We conducted a cross-sectional analysis of 5,735 participants from the 2019 cycle of the Korea National Health and Nutrition Survey (KNHANES), and 928 participants who self-reported as Asian from the 2017-2020 pre-pandemic cycle of the United States National Health and Nutrition Survey (NHANES). We compared the prevalence of CKD (eGFR <60 ml/min/1.73 m2 or urine albumin-to-creatinine ratio ≥30 mg/g) and CKD GFR Stages 3 and higher (eGFR <30, 45, 60 ml/min/1.73 m2) using the 2009 CKD-EPI creatinine equation and the 2021 equation.
Results
In our study, the prevalence of CKD and eGFR <60 ml/min/1.73 m2 were higher in US Asians (mean age 46 years, 55% female, 47.3% hypertension, and 17.5% diabetes) than Koreans (mean age 48 years, 49% female, 49.2% hypertension, and 12.2% diabetes). The CKD prevalence estimates by the 2021 CKD-EPI creatinine equation were slightly lower compared with the estimates by the 2009 equation (-0.63 ± 0.10% for Koreans and -0.56 ± 0.23% for US Asians; Table 1).
Conclusion
The 2021 CKD-EPI creatinine GFR estimating equation without race led to a small decrease in CKD prevalence of similar magnitude in both Korean and US Asian populations.
Prevalence of CKD and eGFR in Korean and US Asian populations, using three eGFR equations
| Korean population (KNHANES 2019) | US Asian population (NHANES 2017-2020 pre-pandemic) | ||||||
| Equation | Number in millions | Weighted percent | Change from eGFRcr(ASR) | Number in millions | Weighted percent | Change from eGFRcr(ASR) | |
| Chronic kidney disease | eGFRcr(ASR), 2009 | 4.66 ± 0.24 | 10.38 ± 0.53 | Ref | 2.00 ± 0.18 | 14.14 ± 1.29 | Ref |
| eGFR(AS), 2021 | 4.38 ± 0.22 | 9.75 ± 0.51 | -0.63 ± 0.10 | 1.92 ± 0.19 | 13.58 ± 1.32 | -0.56 ± 0.23 | |
| eGFR <60 mL/min/1.73 m2 | eGFRcr(ASR), 2009 | 1.13 ± 0.11 | 2.87 ± 0.25 | Ref | 0.53 ± 0.10 | 3.71 ± 0.74 | Ref |
| eGFR(AS), 2021 | 0.87 ± 0.09 | 1.93 ± 0.19 | -0.94 ± 0.14 | 0.38 ± 0.10 | 2.70 ± 0.70 | -1.01 ± 0.34 | |
| eGFR <45 mL/min/1.73 m2 | eGFRcr(ASR), 2009 | 0.36 ± 0.05 | 0.80 ± 0.11 | Ref | 0.16 ± 0.09 | 1.11 ± 0.60 | Ref |
| eGFR(AS), 2021 | 0.28 ± 0.04 | 0.62 ± 0.10 | -0.18 ± 0.05 | 0.14 ± 0.09 | 0.96 ± 0.60 | -0.16 ± 0.09 | |
| eGFR <30 mL/min/1.73 m2 | eGFRcr(ASR), 2009 | 0.09 ± 0.03 | 0.21 ± 0.07 | Ref | 0.08 ± 0.07 | 0.58 ± 0.49 | Ref |
| eGFR(AS), 2021 | 0.08 ± 0.03 | 0.19 ± 0.07 | -0.02 ± 0.02 | 0.07 ± 0.07 | 0.52 ± 0.49 | -0.06 ± 0.06 | |
eGFRcr(ASR), 2009: eGFR estimated by the 2009 CKD-EPI equation using age, sex, and race; eGFRcr(AS), 2021: eGFR estimated by the 2021 CKD-EPI equation using age and sex. All weighted values were proportion ± SE.