Impact of routine reporting of estimated glomerular filtration rate using the European Kidney Function Consortium and Chronic Kidney Disease Epidemiology Collaboration equations in a Western Australian community population

Kathryn Napier, David Lim, Elizabeth Thomas, James Boyd, Aron Chakera, James Williamson, Kim Betts, Justin Manuel, Teodulo Rey Tuando, Suzanne Robinson

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: In 2020, the European Kidney Function Consortium (EKFC) published a new creatinine-based equation to estimate glomerular filtration rate (eGFR) to overcome known limitations in existing equations. The aim of this study is to model the potential impact on service referral and health expenditure of routine reporting of eGFR using the EKFC equation as compared to the CKD-EPI equation in a Western Australian population. Methods: eGFR was calculated for 760 614 patients with 2 368 234 creatinine results using the CKD-EPI and EKFC formulas. Patients were grouped into a CKD cohort if they had at least two eGFR results of <60 ml/min/1.73 m2 from tests at least 90 days apart. The impact of each equation on the reclassification of CKD stages, CKD cohort classification, the rate of change in eGFR and direct health costs were assessed. Results: About 90.66% of patients had a lower eGFR when calculated using the EKFC equation. About 12.6% of individuals were classified into a different CKD stage using the EKFC equation with 97.43% of these patients classified into a higher (more advanced) stage. There was a 25.9% increase in the number of patients identified as having CKD when calculated using the EKFC equation. Direct health costs also increased with the use of EKFC reporting. Conclusion: Use of the EKFC equation will increase population prevalence of CKD and will result in a shift to higher stages of CKD. This has implications for monitoring and referral of patients within specialist services and has the potential to increase the need for multidisciplinary care.

Original languageEnglish
Pages (from-to)823-833
Number of pages11
JournalNephrology
Volume27
Issue number10
Early online date29 Jul 2022
DOIs
Publication statusPublished - Oct 2022

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