CKD-EPI 2021: the race-free equation
The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 equation superseded the 2009 version by removing the race coefficient, which had been criticised for potentially overestimating eGFR in Black patients and thereby delaying CKD diagnosis. The 2021 equation uses only serum creatinine, age, and sex, and has been adopted by NHS England and NICE as the standard formula.
eGFR naturally declines with age in healthy adults — approximately 1 mL/min/1.73m² per year after age 40. An eGFR of 60–89 in an older adult without other markers of kidney damage (e.g., proteinuria, haematuria, structural abnormality) may represent normal ageing rather than CKD. CKD staging requires confirmation over ≥3 months.