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    CKD-EPI Equations for Glomerular Filtration Rate (GFR)

    Estimates GFR based on serum creatinine, serum cystatin C, or both.

    IMPORTANT

    This calculator includes inputs based on race, which may or may not provide better estimates, so we have decided to make race optional. See here for more on our approach to addressing race and bias on MDCalc.

    For the same creatinine value, this calculator estimates a higher GFR for Black patients.

    INSTRUCTIONS

    For use in patients with stable kidney function. While the combined creatinine and cystatin C equation can add accuracy, cystatin c is not available in all laboratories and the creatinine-based equation is adequate for most clinical purposes.

    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients with chronic kidney disease (not acute), to measure renal function.
    • CKD-EPI Creatinine is more commonly available.
    • CKD-EPI Cystatin C is preferred in patients at extremes of body type (e.g. obese patients, high or low muscle mass).
    • Creatinine-based estimates of kidney function by glomerular filtration rate (GFR) are less accurate in certain populations including patients with diabetes (before progression to overt nephropathy with diminished GFR), pregnant women, those with unusual body mass (e.g. 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, and may be particularly helpful in patients for whom creatinine based eGFR may be inaccurate (see above).
    • Debate is emerging about the use of race-based coefficients for calculating eGFR, and some labs no longer report differences in eGFR based on race.
    • Not for use in patients on dialysis.

    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 an eGFR of <60 mL/min/m2. It is used most widely by nephrologists and understood to be the most accurate means of non-invasively assessing GFR in the United States.

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

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights
    Dr. Andrew S. Levey

    About the Creator

    Andrew S. Levey, MD, is the chief of the nephrology division at Tufts Medical Center and the Dr. Gerald J. and Dorothy R. Friedman Professor at Tufts University School of Medicine. His clinical interests include chronic kidney disease (CKD), diabetic kidney disease, and systemic lupus erythematosus. Dr. Levey’s research focuses on laboratory measures to estimate kidney function, new therapies, and the development of clinical practice guidelines for CKD.

    To view Dr. Andrew S. Levey's publications, visit PubMed

    Are you Dr. Andrew S. Levey? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Omar Aziz, MD
    • Evan Zeitler, MD
    About the Creator
    Dr. Andrew S. Levey
    Are you Dr. Andrew S. Levey?
    Content Contributors
    • Omar Aziz, MD
    • Evan Zeitler, MD