Comparative performance of CKD-EPI equations in people with diabetes: An international pooled analysis of individual participant data
Authors' conclusion
The use of CKD-EPI equations has the potential for misdiagnosis and suboptimal CKD management in people with diabetes. Alternative methods of estimating kidney function for people with diabetes are needed to optimally manage diabetes-related kidney disease.
Study context
- Population
- Individuals with diabetes from six international diabetes cohorts: T1D (n = 1,748, median age 33 years, measured glomerular filtration rate (mGFR) 104.2 ml/min per 1.73 m²) and T2D (n = 3,429, median age 66 years, mGFR 58.4 ml/min per 1.73 m²)
- Participants
- 5,177 individuals6 cohorts
- Comparison
- Creatinine-based CKD-EPI-2009 and CKD-EPI-2021 estimates of GFR (eGFR) vs measured GFR
- Outcome
- Concordance and misclassification of chronic kidney disease (CKD) stages between mGFR and eGFR (ICC, bias, precision, accuracy)
Methodological detailsinternational pooled analysis of individual participant data, six cohorts, Four-level mixed-effect linear variance component model
- International pooled analysis of individual participant data
- Six cohorts
- Four-level mixed-effect linear variance component model
Performance
As reported in the abstract
Agreement, bias, precision and accuracy vs mGFR
| Test or model | ICC | Bias | Precision | Accuracy p30 |
|---|---|---|---|---|
| CKD-EPI-2009 | 0.90 | 3.7 ml/min/1.73 m² | 12.4 ml/min/1.73 m² | 77 % |
| CKD-EPI-2021 | 0.87 | 8.6 ml/min/1.73 m² | 13.91 ml/min/1.73 m² | 70 % |
ICC
CKD-EPI-20090.90
CKD-EPI-20210.87
Bias
CKD-EPI-20093.7 ml/min/1.73 m²
CKD-EPI-20218.6 ml/min/1.73 m²
Precision
CKD-EPI-200912.4 ml/min/1.73 m²
CKD-EPI-202113.91 ml/min/1.73 m²
Accuracy p30
CKD-EPI-200977 %
CKD-EPI-202170 %
Original publication
Comparative performance of CKD-EPI equations in people with diabetes: An international pooled analysis of individual participant data. Diabetes Res Clin Pract. Published 15 March 2025. doi:10.
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