Estimates glomerular filtration rate without race
Total Score
G5: Kidney failure (ESRD). Initiate renal replacement therapy if not already. Urgent nephrology review.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.
The CKD-EPI 2021 equation estimates Glomerular Filtration Rate (eGFR) based on serum creatinine, age, and sex. This updated guideline explicitly removed the race modifier to eliminate healthcare disparities and is now the globally recommended standard by the NKF and ASN for diagnosing and staging Chronic Kidney Disease (CKD).
While eGFR is excellent for staging stable chronic kidney disease, it is completely invalid in acute kidney injury (AKI) where serum creatinine is rapidly fluctuating. The formula assumes a steady state of creatinine generation and excretion.
Inker LA, Eneanya ND, Coresh J, et al. New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race. N Engl J Med. 2021;385(19):1737-1749.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Use to estimate GFR in adult patients (≥ 18 years) for CKD staging, medication dose adjustment, and nephrology referral decisions. The 2021 race-free CKD-EPI equation is endorsed by KDIGO 2022 and the NKF-ASN Joint Task Force as the replacement for the 2009 race-inclusive equation. CKD diagnosis requires an eGFR < 60 mL/min/1.73m² OR a kidney damage marker (albuminuria ≥ A2, abnormal imaging, pathology) persisting for > 3 months.
eGFR is less reliable at extremes of body habitus. In sarcopenic elderly patients, very low muscle mass means serum creatinine is disproportionately low, and the calculated eGFR will overestimate true GFR — sometimes dramatically. In these patients, a cystatin C-based or combined creatinine-cystatin C eGFR provides superior accuracy. Similarly, body builders with high muscle mass will have elevated creatinine and underestimated eGFR.
Acute kidney injury (AKI) is NOT staged using eGFR. The CKD-EPI equation assumes a steady-state creatinine reflecting stable GFR; a rapidly rising creatinine in AKI will underestimate the true reduction in GFR. In AKI, use serial creatinine trends, urine output criteria (KDIGO AKI staging), and clinical context — not eGFR — to guide management.