New eGFR calculation Coming.: Just received... - Kidney Disease

Kidney Disease

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New eGFR calculation Coming.

MartyVA profile image
18 Replies

Just received an email from the NKF announcing a new method for calculating eGFR. See link below for details.

kidney.org/newsletter/chang...

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MartyVA profile image
MartyVA
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18 Replies
rabbit01 profile image
rabbit01

Thanks that's interesting.

Marvin8 profile image
Marvin8

If you're black, this matters a lot. If you're not, there's also some important changes in that there's more of a push to use CYSTATIN-C along with creatinine in the ckd-epi combined formula. I've been proselytizing for folks to request a cystatin-c test for quite some time now. Search my posts and you'll see the reasons why.

Skeptix profile image
Skeptix in reply to Marvin8

This makes you something of a prophet as well as a proselytiser. :)

Sophiebun11 profile image
Sophiebun11 in reply to Marvin8

I read your post and my new N. ordered that test on my next set of labs. Thanks for the info. I'll be interested to see if it changes my GFR number.

Marvin8 profile image
Marvin8 in reply to Sophiebun11

One thing to note is that your cystatin based eGFR should be higher than your creatinine eGFR for a better prognosis. The other thing to note is that thyroid problems can throw off the cystatin numbers.

Sophiebun11 profile image
Sophiebun11 in reply to Marvin8

Thanks Marvin for mentioning that point, I do have hypothyroid. I guess I'd better just leave it up to my N. and the lab to figure it all out.

Marvin8 profile image
Marvin8 in reply to Sophiebun11

Never a bad idea. Just be sure to ask him how much he knows about cystatin-c first.Some actually don't know very much. And general practitioners know a lot less.

FThomp profile image
FThomp in reply to Marvin8

I’m getting a cystatin test after meeting with a Neoh. My most recent lab put me at 86 for non aa and 100 for aa. I’m not black but I am more muscular than the avg person at 6’2 so I’m interested to see the difference with the C test!

Skeptix profile image
Skeptix

'Jumped' from 29 to 31 (using creatinine only)

Must get a cystatin c check done next bloods and see what happens..

userotc profile image
userotc in reply to Skeptix

Mum's has gone from 76 to 80 umol/l so slightly less increase than yours. But she's delighted! Lol. Obviously the trend is more important than the absolute figure.

Skeptix profile image
Skeptix in reply to userotc

I wonder what would have happened if the boffins had arrived up at the NKF committee, presenting their new algorithm giving you a worse eGFR figure than before...

userotc profile image
userotc in reply to Skeptix

Good point. Maybe sack the lot of them if it meant more testing requested by worried patients? I do wonder if the NHS can stand the extra cost of cystatin tests.

Stavrosang profile image
Stavrosang in reply to Skeptix

Did you also remove the body weight adjustment and put in the numbers manually? That also seemed to give me a bit extra on the top of the already nice bonus

Skeptix profile image
Skeptix in reply to userotc

I know. But walking around town with a Nieman Marcus shopping bag just makes you feel better even if it's only made of paper. Take every + :)

barbara55109 profile image
barbara55109

This is HUGE and wonderful for people of color in the US. My understanding is that other countries did not use the race based scores. Black americans have been denied early treatment and access to transplant waiting lists for too long.

Darlenia profile image
Darlenia

This is wonderful news. Glad to see the NKF actively working on the issue.

Sophiebun11 profile image
Sophiebun11

That is good news. Everyone should get treated as early and the same regardless of race. I just looked at my last GFR and if I were a POC my GFR would be 5 points higher and I probably wouldn't be seeing the Nephrologist yet. I'm at GFR 29 but would only be at 34 which sounds better but isn't. Maybe no one's GFR is correct. Maybe we will all be lower or higher using the new method. I'll be anxious to see at my next N. appt. since he ordered that cystatin-c test.

RoxanneKidney profile image
RoxanneKidney

There is likely a 5 +/- range for GFR. This is why it is probably important to have your blood work done at the same place all the time so they use the same formulas for calculating numbers. For example, I had blood work for creatinine done in Wickenburg AZ, and they sent the SAME vile/sample to Mayo in MN and the difference in cratinine was 1.1 in Wickenburg to 1.25 in MN. That appears to be a statistically significant difference. A month later back to 1.3 at another clinic. According to the NKF, this range is GFR 59-GFR 48 (over 10 points) ...but my Cystine C has not changed 1.26/GFR 54. But then again, my problem is the protein, so thankfully someone finally checked me for that instead of watching my GFR slowly drop smh.

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