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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
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    CKD-EPI Equations for Glomerular Filtration Rate (GFR)

    Estimates GFR based on serum creatinine, serum cystatin C, or both.
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    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients with chronic kidney disease (not acute), to measure renal function.
    • CKD-EPI Cystatin C is preferred in cirrhotics and other patients with low muscle mass.
    • CKD-EPI Creatinine can be used in settings where cystatin C is not available.  
    • Creatinine-based estimates of kidney function by glomerular filtration rate (GFR) are less accurate in certain populations including diabetics with high GFR, pregnant women, those with unusual body mass (obese, severely malnourished, amputees, paraplegics, etc).
    • Cystatin C-based estimates vary based on factors still being studied including age, race and gender.
    • Creatinine estimates alone are more accurate than cystatin C-based estimates.
    • Used together, creatinine and cystatin C estimates are more accurate than using either alone.

    The CKD-EPI equation performs superiorly to the MDRD Equation in patients with normal or mildly reduced estimated GFR (eGFR), and just as well in patients with less than normal eGFR.

    CKD-EPI Creatinine
    CKD-EPI Cystatin C
    CKD-EPI Creatinine–Cystatin C
    Female
    Male
    years

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Patients with deranged GFR need dose adjustments for renally-cleared medications.

    Management

    Patients should be classified in stages of CKD for grading severity, mortality, and management and referred early to a nephrologist.

    CKD Stage

    GFR, mL/min/1.73 m2

    I

    ≥90

    II

    60–89

    IIIa

    45–59

    IIIb

    30–44

    IV

    15–29

    V

    <15

    From KDIGO 2012 Clinical Practice Guideline.

    Content Contributors
    • Omar Aziz, MD
    About the Creator
    Dr. Andrew S. Levey
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    Content Contributors
    • Omar Aziz, MD