Abstract: TH-PO1000
Potential Implications of 2021 CKD-EPI Equation in Patients with CKD from British Columbia, Canada
Session Information
- CKD Epidemiology, Risk Factors, Prevention - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Atiquzzaman, Mohammad, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Er, Lee, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Djurdjev, Ognjenka, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Bevilacqua, Micheli U., BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Birks, Peter C., BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Wong, Michelle M.Y., BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Levin, Adeera, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
Background
One in 10 British Columbians has kidney disease. The implications of implementing 2021 CKD-EPI equation in British Columbia (BC) is unknown. This was investigated in a population-level cohort of CKD patients from BC, Canada.
Methods
CKD patients aged ≥19 years and registered in the “Provincial Renal Program” on March 31, 2023 (index date) were included. Patients needed to have ≥1 serum creatinine recorded within 1 year before index date. We excluded patients who received transplantation before index date. We calculated eGFR using CKD-EPI 2009 and 2021 equations, and estimated the mean difference in eGFRs and corresponding Kidney Failure Risk Equation (KFRE) 2-year risks by age and sex. We assessed the implications in two clinical aspects: (1) reclassification between eGFR categories (G1-G5) (2) reclassification between KDIGO risk categories (low, moderately increased, high and very high risk). Finally, we investigated patient characteristics among those who were reclassified in eGFR categories (switcher; yes/no).
Results
Study sample included 16,037 patients, median age 74 years, 54% male. Compared to 2009 equation, eGFR calculated using 2021 equation was on average 1.80-2.60 ml/min higher in women and 2.86-3.33 ml/min higher in men. The 2021 equation downgraded the CKD severity with highest % of patients downgraded in G5 category (Fig.1). In KDIGO risk categorization, ~4% of patients in the very high risk group were reclassified to a lower risk group. The switchers appeared to be older male, majority (~43%) were in eGFR category G4 followed by 27% in G3b. KFRE 2-year risk score calculated using eGFR from 2021 equation was lower compared to that of estimated using eGFR from 2009 equation, median (IQR) in difference was -0.854 (-2.516, -0.258). Difference was larger in males.
Conclusion
The eGFR calculated using CKD-EPI 2021 was higher compared to 2009 equation. A large number (~17%) of patients currently under the care of nephrologists in BC would have categorically less severe CKD. The implications of this on resource utilization, care plans and outcomes are unknown.