•  
  •  
 

Turkish Journal of Medical Sciences

Abstract

Background/aim: The 2021 revision of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, which eliminates race-based coefficients, may significantly influence disease staging and treatment in autosomal dominant polycystic kidney disease (ADPKD). This study was designed to evaluate the impact of the 2021 race-free CKD-EPI equation on estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) staging in a multi-ethnic ADPKD population.

Materials and methods: In this multicenter, retrospective cohort study, 597 ADPKD patients were evaluated, including 515 self-identified as Caucasian and 82 as African-American. eGFR values at baseline and final follow-up were calculated using both the 2009 and 2021 CKD-EPI equations. Changes in CKD staging and clinical implications were assessed based on the race-free equation.

Results: Among Caucasian patients, the median baseline eGFR increased from 85.0 to 88.6 mL/min/1.73 m² and the final eGFR from 63.1 to 66.1 mL/min/1.73 m² using the 2021 equation (p < 0.001). In contrast, the 2021 equation resulted in decreased eGFR among African-American patients, from 89.3 to 80.3 mL/min/1.73 m² at baseline and from 46.8 to 42.6 mL/min/1.73 m² at final follow-up (p < 0.001). A total of 6.7% of Caucasian patients were downstaged initially and 5.7% at final follow-up. Conversely, 2.3% of African- American patients were upstaged at baseline and 1.8% at final follow-up.

Conclusion: The 2021 CKD-EPI equation significantly alters eGFR estimation and CKD staging compared to the 2009 version, with varying impacts across ethnic groups. These findings highlight the importance of careful interpretation of eGFR and individualized clinical decision-making in patients with ADPKD.

Author ORCID Identifier

ÖZGÜR OTO: 0000-0003-0928-8103

ABDULMECİT YILDIZ: 0000-0001-5941-9103

İSMAİL KOÇYİĞİT: 0000-0002-6654-4727

HALİL YAZICI: 0000-0003-2526-3483

SAİDE GÜLLÜLÜ BOZ: 0000-0001-6048-1879

YİĞİT KURTULUŞ: 0009-00086324-63-54

ALPARSLAN DEMİRAY: 0000-0002-6305-3201

MÜGE DOKSAN: 0009-0009-6488-5964

VAFA SULEYMANOVA: 0000-0002-5184-4188

ECE ÜK: 0000-0003-0343-4886

ALPER AKIN: 0000-0002-5911-6791

BAHAR BASTANI: 0000-0002-2138-4248

JOHN EDWARDS: 0000-0002-0500-716X

KRISTA LENTINE: 0000-0002-9423-4849

YAŞAR ÇALIŞKAN: 0000-0003-3816-8047

DOI

10.55730/1300-0144.6212

Keywords

Autosomal dominant polycystic kidney disease, chronic kidney disease staging, CKD-EPI equation, estimated glomerular filtration rate, race-free equation

First Page

787

Last Page

793

Publisher

The Scientific and Technological Research Council of Türkiye (TÜBİTAK)

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Download

Share

COinS