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Abstract: TH-PO1034

Performance Evaluation of CKD-EPI Equations for Estimated Glomerular Filtration Rate Compared with Inulin Clearance in Koreans

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials


  • Cho, Jeongmin, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Cha, Ran-hui, National Medical Center, Jung, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Chin, Ho Jun, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)

A race-free glomerular filtration rate (GFR) estimation equation has recently been developed. However, the performance of the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations needs to be evaluated in Asian populations.


We performed a cross-sectional study at a single center in South Korea. The measured GFR (mGFR) was determined based on systemic inulin clearance. The GFR was estimated using the following five CKD-EPI equations incorporating creatinine (cr), cystatin C (cys), and cystatin C and creatinine (cr-cys): 2009 CKD-EPIcr, 2012 CKD-EPIcr-cys, 2012 CKD-EPIcys, 2021 CKD-EPIcr, and 2021 CKD-EPIcr-cys.


The bias of 2009 CKD-EPIcr (2.24) and 2012 CKD-EPIcr-cys (6.74) were lower than those of 2021 CKD-EPI equations (5.40 and 10.54 mL/min/1.73 m2). The accuracy of the five eGFR equations measured as the percentage of study participants with eGFR values within 30% of the mGFR of original CKD-EPIcr and CKD-EPIcr-cys were higher than those of 2021 equations (85.4 vs. 83.3% and 84.1 vs. 80.8%). The overall concordance rate between mGFR and estimated GFR was higher in the 2009 CKD-EPIcr (0.393) and 2012 CKD-EPIcr-cys (0.473) than in the 2021 CKD-EPIcr-cys (0.372 and 0.456). The CKD prevalence in 2009 CKD-EPIcr, 2021 CKD-EPIcr, 2012 CKD-EPIcr-cys, and 2021 CKD-EPIcr-cys was 54.8%, 51.0%, 47.7%, and 44.8%, respectively.


Our study demonstrated better performance of the original CKD-EPIcr and CKD-EPIcr-cys equations than the 2021 new CKD-EPI equations. We do not recommend the adoption of the new CKD-EPI equations in Korea.

Figure 1. Bland-Altman plots for the concordance rate between mGFR and eGFR.

Figure 2. Performance comparison between five glomerular filtration rate-estimating equations