eGFR (CKD-EPI 2021)

CKD-EPI 2021 Estimated GFR

The CKD-EPI 2021 equation estimates the glomerular filtration rate (eGFR) from serum creatinine, age and sex, reporting the result in mL/min/1.73 m². The 2021 update removed the race coefficient that the original 2009 version applied to Black patients, improving equity and precision across populations. Serum creatinine may be entered in mg/dL or converted from µmol/L (divide by 88.4).

eGFR classifies chronic kidney disease (CKD) into stages per KDIGO and the Brazilian Society of Nephrology (SBN): G1 ≥ 90 (normal or high, with kidney damage), G2 60-89 (mildly decreased), G3a 45-59 (mild-to-moderate), G3b 30-44 (moderate-to-severe), G4 15-29 (severe) and G5 < 15 (kidney failure, dialysis territory).

Applications

Used in CKD screening and follow-up, in pre-operative renal risk, in oncology before nephrotoxic chemotherapy, and in routine reports of biochemistry labs. KDIGO recommends combining eGFR with albuminuria (uACR) for full CKD risk classification. Disclaimer: educational tool — for clinical decisions confirm with cystatin C or measured GFR when needed.

FAQ

Why no race coefficient in 2021? The race adjustment was based on small US cohorts and lacked biological rationale; KDIGO and major US societies endorsed the race-free 2021 equation in 2021-2022.

Should I add cystatin C? The combined CKD-EPI creatinine + cystatin C equation is more accurate, especially near the 60 mL/min cutoff and in atypical body composition. Use it when creatinine-based eGFR seems inconsistent with clinical findings.

Is eGFR ≥ 60 normal? Not necessarily — CKD G1 and G2 require kidney damage markers (albuminuria, abnormal imaging or histology). Always interpret eGFR with urine albumin-to-creatinine ratio.