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Comment & Response
July 20, 2020

Estimating Glomerular Filtration Rate in African American Individuals

Author Affiliations
  • 1CHU Sart Tilman, Department of Nephrology-Dialysis-Transplantation, University of Liège, Liège, Belgium
  • 2Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nimes, France
  • 3Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
JAMA Intern Med. Published online July 20, 2020. doi:10.1001/jamainternmed.2020.2352

To the Editor Levey et al1 argue that the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is the most accurate tool for determining glomerular filtration rate (GFR) in African American people. However, this conclusion is questionable. First, as we established in 2011, the current CKD-EPI equations with the ethnic African American coefficient underestimate GFR in African American patients with chronic kidney disease (CKD) but overestimate it in African American patients who do not have CKD.2 Because the mean bias of this equation crosses the line of zero bias, it is quite challenging to know the real prevalence of CKD in this specific population. It must be reiterated here that the CKD-EPI equation with the African American patient correction factor has been developed and validated in cohorts including a vast majority of patients with CKD. We thus think that the current data are not suitable to determine the real performance of such an equation in African American patients who do not have CKD.

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