20 August 2024
2 minutes reading time
Key findings:
- The prevalence of chronic kidney disease, measured using the 2021 creatinine formula, was 9.75% in Korean patients.
- The CKD prevalence measured using the 2021 equation was 11.60% among Asian patients in the United States.
According to a published study, using the 2021 Chronic Kidney Disease-Epidemiology Collaboration creatinine equation found lower rates of CKD among Korean and U.S.-based Asian populations.
The equation resulted in a reclassification of patients who were initially thought to be in CKD stage G3 or higher.
“The prevalence of CKD in Asian countries as well as the etiology of CKD vary greatly by region,” Jimin HwangMD, from the University of Texas Southwestern Medical Center and the Johns Hopkins Bloomberg School of Public Health, wrote with colleagues. “In the United States, Asian Americans have a higher prevalence of elevated albuminuria and a lower likelihood of a reduction in eGFR compared with the white population, potentially mitigating the impact of changes in GFR estimation algorithms.”
The Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) creatinine equation updated the eGFR calculation by removing the racial coefficient. According to the study, the racial distribution became binary by using black and “non-black” groups, and included few Asian participants.
Hwang and colleagues conducted an observational study using national surveys to understand the difference between the equations for estimates in two Asian populations from 2021 and 2009.
The study included patients from the 2019 Korean National Health and Nutrition Survey and patients who reported as Asian from the 2011-2020 US National Health and Nutrition Survey. The main outcomes were CKD prevalence, defined as eGFR of less than 60 mL/min/1.73 m2 or a urine albumin-creatinine ratio of at least 30 mg/g.
The CKD prevalence measured using the 2021 CKD-EPI formula was 9.75% in Korean patients and 11.60% in Asian patients from the US, according to the study. This prevalence was slightly lower than that found using the estimated 2009 formula, with a decrease of 0.63% in Korean patients and 0.84% in Asian patients from the US. The researchers also found that a significant percentage of patients originally classified as having CKD G3 to G5 using the 2009 formula were reclassified as not having CKD G3 to G5 using the 2021 formula; this reclassification applied to 32.8% of Korean patients and 30.2% of Asian patients from the US.
“In summary, the introduction of the 2021 equation resulted in a reduction in CKD prevalence in Korean and US Asian populations, with the decline being even greater in the older population,” the researchers wrote. “Nearly one-third of individuals with CKD G3 (to) 5 according to the 2009 equation were reclassified as without CKD G3 (to) 5 according to the 2021 equation, and the majority of these were individuals aged 65 (years) or older.
“To better understand the effect of the new equation, further studies are needed to evaluate bias and accuracy,” the researchers wrote.
Sources/Disclosures
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Announcement: Hwang reports support from the NIH and the National Institute of Diabetes and Digestive and Kidney Diseases. Relevant financial disclosures for all other authors can be found in the study.
