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Abstract: FR-PO934

Performance of Race Neutral CKD-EPI 2021 eGFR Equations in Indian Population

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention


  • Johal, Prabhjot Kaur, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
  • Yadav, Ashok Kumar, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
  • Kumar, Vivek, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
  • Jha, Vivekanand, The George Institute for Global Health, New Delhi, New Delhi, India

Recently, race neutral CKD-EPI 2021 equations have been described. As these equations are being adopted in clinical use, it is important to validate these estimating glomerular filtration rate (eGFR) equations in Indian population. We present the performance of these equations against measured GFR (mGFR) in Indian subjects.


In the ongoing ‘Indian GFR study’, healthy individuals or stable patients with chronic kidney disease (CKD) are being enrolled with the objective of testing performance of eGFR equations in Indian population. Demographic details, anthropometric measurements, diagnosis, treatment and dietary details are being recorded. GFR was measured using urinary clearance of inulin in the first 130 subjects. Thereafter, it is being measured by plasma clearance of iohexol. Bias, precision, and accuracy of CKD-EPI 2021 equations were calculated. We present data of participants whose measurements were available till October 2021.


mGFR was available for 412 participants (187 healthy and 225 with CKD). Average age was 47.2±11.5 years, 50% being males. Mean mGFR in study population was 54.23±30.21 ml/min/1.73m2. eGFR using CKD-EPICr2021 and CKD-EPICr-cys2021 were 73.45±38.37 ml/min/1.73m2 and 60.81±33.58 ml/min/1.73m2, respectively. Bias for CKD-EPICr2021 and CKD-EPICr-cys2021 equations were -19.22±21.55 ml/min/1.73m2 and -6.58±19.19 ml/min/1.73m2, respectively. eGFR by CKD-EPICys had least bias and highest P30 (table 1).


Race neutral CKD-EPI 2021 equations did not enhance performance of eGFR equations in Indian subjects. There is a need for extensive validation of eGFR equations in Indian population.

Table 1. Performance of GFR estimating equations as compared to measured GFR
MethodBias95% Limits of agreementPrecision
(95% CI)
RMSEP30 (%)
CKD-EPICr2009-17.04±21.3624.82 to -58.90-19.11 to -14.9727.3143.20
CKD-EPICr2021-19.22±21.5523.01 to -61.45-21.31 to -17.1328.8641.50
CKD-EPICr-cys2012-0.86±18.4035.20 to -36.92-2.64 to 0.9118.4059.95
CKD-EPICr-cys2021-6.58±19.1931.03 to -44.19-8.44 to -4.7220.2755.82
CKD-EPICys3.56±19.2941.36 to -34.241.69 to 5.4319.5960.92

P30: Percentage of participants with eGFR within ±30% of mGFR, RMSE: root mean square error Values are in ml/min/1.73m2 except P30


  • Government Support – Non-U.S.