From 17 March 2020, a new equation for the calculation of estimated glomerular filtration rate in patients with Chronic Kidney Disease (CKD) suggested in the NICE guideline on CKD (2014)1 will be implemented.
BHRUT’s biochemistry laboratories have been providing an estimated glomerular filtration rate (eGFR) alongside creatinine results for some time. The eGFR is currently calculated using the Modification of Diet in Renal Disease (MDRD) Study equation. This gives an approximation of GFR, assuming that the patient resembles average patients of their age and gender (see ‘important points to note’ below) and that renal function is stable.
In the updated CKD guidelines (CG182), NICE now recommend the use of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to calculate eGFR. This equation has been found to be more accurate than the MDRD, is less biased at a GFR of more than 60 ml/min/1.73m2 and performs better in people aged 75 years and over.
As recommended by NICE, the laboratories will be implementing the CKD-EPI equation to calculate eGFR. This implementation may result in changes to the classification of some patients with CKD. The CKD-EPI equation is more accurate in patients with near normal GFR, thus we will start reporting eGFR up to 90 ml/min/1.73m2. Please note that an eGFR of >60 only indicates CKD if there is other evidence of kidney disease. As with the CKD-MDRD equation, CKD-EPI eGFR will also require adjustment for people of African-Caribbean or African family origin (multiply eGFR by 1.159).
For more information, please contact the Renal and Biochemistry teams directly on:
1NICE (July 2014). Chronic Kidney Disease - Early identification and management of chronic kidney disease in adults in primary and secondary care. (CG182).
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