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CKD-EPI 2021 Race Coefficient Removal — ESENeph MCQ

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EasyChronic Kidney DiseaseCKD-EPI 2021 Race Coefficient RemovalESENeph

A 45-year-old man with CKD G3a has an eGFR of 58 measured using the CKD-EPI 2021 creatinine equation (which no longer includes a race coefficient). What is the rationale for removing the race variable from the CKD-EPI equation?

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Correct answer: D — The race coefficient was removed because race is a social construct, not a biological variable; the coefficient perpetuated health disparities by systematically overestimating eGFR in Black individuals (potentially delaying diagnosis, referral, and treatment); the 2021 equation uses creatinine and/or cystatin C without race

The CKD-EPI 2021 equation removed the race coefficient following an NKDEP/ASN task force recommendation. The rationale: (1) race is a social construct with no biological basis for kidney function estimation; (2) the coefficient was derived from a limited US dataset and not universally applicable; (3) it systematically overestimated eGFR in Black individuals, potentially delaying CKD diagnosis, specialist referral, and transplant listing; (4) combined creatinine-cystatin C equation without race provides equivalent or better accuracy. KDIGO 2024 recommends the race-free CKD-EPI 2021 equation or eGFRcr-cys.

Reference: KDIGO 2024 – CKD; Inker et al 2021 – CKD-EPI 2021 Race-Free