Kidney disease burden in an Asian Indian population: Effect of the new 2021 serum creatinine CKD-EPI equation

Published:October 18, 2022DOI:


      • In an Asian cohort, the 2021 equation showed a positive bias by increasing the eGFR.
      • The 2021 CKD-EPI lowered estimated kidney burden (eKDB).
      • Lowering in eKDB increased with age, independent of presence of T2DM and HTN.



      CKD-EPI (chronic kidney disease-epidemiological) serum creatinine equation is widely accepted for calculating estimated glomerular filtration rate (eGFR). The effect of transitioning from the older 2009 to the newer race-independent 2021 CKD-EPI equation on the estimated kidney disease burden (eKDB) was studied in an Asian-Indian population.


      The study included 1156 adults, the two equations were compared for agreement (Bland-Altman and Cohen’s kappa) and concordance (Lin’s correlation and test for proportions).


      The 2021 CKD-EPI increased the eGFR (positive-bias), independent of age-group, gender or presence of type 2 diabetes mellitus (T2DM) and hypertension (HTN). Thus, the eKDB was significantly decreased by 2021 CKD-EPI equation. The agreement was highest for the age-group 31–40 years (95.8 % versus 87.5 % for > 50 years). Besides, the eGFR category was shifted from G3 to G1 in 8.2 % (95 % CI: 6.8–9.9) individuals by 2021 CKD-EPI. The effect of transition on eKDB was greater in individuals > 50 years (7.4 %) or with HTN (6.3 %).


      In comparison to the old equation, the 2021 CKD-EPI equation increased the eGFR, lowering the eKDB in this Asian-Indian cohort. The degree of lowering was affected by age-group, and presence of T2DM /HTN, but independent of gender.


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