2009 CKD-EPI glomerular filtration rate estimation in Black individuals outside the United States: a systematic review and meta-analysis

ABSTRACT Background The 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is the most used to estimate glomerular filtration rate (GFR), with race being a factor thereof, increasing GFR by 16% in self-identified Black persons compared non-Black persons. However, recent publications indicate that it might overestimate for adults outside USA. In this meta-analysis, we assessed accuracy, evaluated percentage of estimated within 30% measured (P30), CKD-EPI estimating and without coefficient individuals United States America (USA). Methods We searched MEDLINE Embase from inception 9 July 2022, no language restriction, supplemented manual reference searches. Studies P30 accuracy or USA an adequate method measurement were included. Data extracted independent pairs reviewers pooled using random-effects model. Results included 11 studies, total 1834 South America, Africa Europe. significantly decreased {61.9% [95% confidence interval (CI) 53–70%] versus 72.9% CI 66.7–78.3%]; P = .03}. Conclusions Outside USA, should not be coefficient, even though sufficiently accurate either way (<75%). Thus endorse Disease: Improving Global Outcomes guidelines use exogenous markers when may impact clinical conduct.