eGFR Calculation for 53-Year-Old Male with Creatinine 111 µmol/L
Using the CKD-EPI equation (the recommended standard), this patient's eGFR is approximately 68 mL/min/1.73 m², indicating preserved kidney function just above the threshold for chronic kidney disease. 1
Calculation Method
The CKD-EPI equation is the preferred method for estimating GFR in adults, as it demonstrates superior accuracy compared to MDRD, particularly at GFR ≥60 mL/min/1.73 m². 1
Converting Creatinine Units
- Creatinine 111 µmol/L = 1.26 mg/dL (conversion factor: µmol/L ÷ 88.4 = mg/dL) 1
CKD-EPI Formula Application
- For a 53-year-old male with serum creatinine 1.26 mg/dL: 1
- GFR = 141 × min(SCr/0.9,1)^-0.411 × max(SCr/0.9,1)^-1.209 × 0.993^age
- Since SCr/0.9 = 1.4 (>1), we use: 141 × 1^-0.411 × 1.4^-1.209 × 0.993^53
- eGFR ≈ 68 mL/min/1.73 m²
Alternative Calculations for Context
- MDRD equation yields approximately 62 mL/min/1.73 m², but this formula is less accurate at higher GFR levels and tends to underestimate kidney function 1, 2
- Cockcroft-Gault requires body weight and is primarily used for medication dosing adjustments rather than CKD staging 1, 3
Clinical Interpretation
This patient has Stage 2 kidney function (GFR 60-89 mL/min/1.73 m²) if kidney damage markers are present, or normal age-appropriate kidney function if no damage markers exist. 4
Risk Stratification
- eGFR of 68 mL/min/1.73 m² carries no significantly increased cardiovascular or mortality risk from kidney function alone, as it remains above the critical 60 mL/min/1.73 m² threshold 4
- The presence or absence of albuminuria is the critical determinant of whether this represents CKD requiring intervention 1, 4
Essential Next Steps
- Measure urinary albumin-to-creatinine ratio (UACR) on a spot urine sample to determine if kidney damage is present (normal <30 mg/g) 1, 4
- Repeat creatinine measurement in 3-6 months to confirm stability, as single measurements can be affected by recent exercise, infection, or dietary protein intake 3
- If UACR is elevated (≥30 mg/g), this patient would be classified as having CKD Stage 2 (G2A2 or G2A3 depending on albuminuria severity) 1
Important Clinical Considerations
The CKD-EPI equation reclassifies approximately 30% of patients with borderline kidney function to lower risk categories compared to MDRD, with these reclassified patients demonstrating genuinely lower mortality and cardiovascular event rates. 2
Medication Management
- At eGFR 68 mL/min/1.73 m², no routine medication dose adjustments are required for most renally-excreted drugs 1
- Continue standard dosing unless specific medications have adjustment thresholds above 60 mL/min/1.73 m² 1
Monitoring Strategy
- If no albuminuria is present, annual monitoring of creatinine and eGFR is sufficient 1
- If albuminuria is detected, increase monitoring frequency to 2-3 times yearly and optimize blood pressure control 3
- Watch for eGFR decline >4-8 mL/min per year, which would indicate accelerated kidney disease requiring nephrology referral 4