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Abstract: TH-PO743

The Impact of the New Creatinine-Based GFR Estimating Equation Without Race in Korean and US Asian Populations

Session Information

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)
 EquationNumber in millionsWeighted percentChange from eGFRcr(ASR)Number in millionsWeighted percentChange from eGFRcr(ASR)
Chronic kidney diseaseeGFRcr(ASR), 20094.66 ± 0.2410.38 ± 0.53Ref2.00 ± 0.1814.14 ± 1.29Ref
eGFR(AS), 20214.38 ± 0.229.75 ± 0.51-0.63 ± 0.101.92 ± 0.1913.58 ± 1.32-0.56 ± 0.23
eGFR <60 mL/min/1.73 m2eGFRcr(ASR), 20091.13 ± 0.112.87 ± 0.25Ref0.53 ± 0.103.71 ± 0.74Ref
eGFR(AS), 20210.87 ± 0.091.93 ± 0.19-0.94 ± 0.140.38 ± 0.102.70 ± 0.70-1.01 ± 0.34
eGFR <45 mL/min/1.73 m2eGFRcr(ASR), 20090.36 ± 0.050.80 ± 0.11Ref0.16 ± 0.091.11 ± 0.60Ref
eGFR(AS), 20210.28 ± 0.040.62 ± 0.10-0.18 ± 0.050.14 ± 0.090.96 ± 0.60-0.16 ± 0.09
eGFR <30 mL/min/1.73 m2eGFRcr(ASR), 20090.09 ± 0.030.21 ± 0.07Ref0.08 ± 0.070.58 ± 0.49Ref
eGFR(AS), 20210.08 ± 0.030.19 ± 0.07-0.02 ± 0.020.07 ± 0.070.52 ± 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.