What is the estimated Glomerular Filtration Rate (eGFR) for a 53-year-old male with a creatinine level of 111?

eGFR Calculation for 53-Year-Old Male with Creatinine 111 µmol/L

Using the 2021 CKD-EPI equation without race, this patient's eGFR is approximately 68 mL/min/1.73 m², indicating normal to mildly reduced kidney function (CKD Stage 2 if kidney damage is present, or normal if no other evidence of kidney disease). 1

Calculation Method

The CKD-EPI equation refit without race variable is the current standard recommended by the NKF-ASN Task Force for GFR estimation. 1 This equation provides superior accuracy compared to the MDRD equation, particularly at GFR values >60 mL/min/1.73 m². 2, 3

Converting Creatinine Units

• Creatinine 111 µmol/L = 1.26 mg/dL (conversion factor: divide by 88.4) 4

Applying the CKD-EPI 2021 Equation

For a 53-year-old male with serum creatinine 1.26 mg/dL:

• eGFR ≈ 68 mL/min/1.73 m² 1, 2
• This calculation uses age, sex, and standardized serum creatinine without race coefficients 1

Clinical Interpretation

This eGFR of 68 mL/min/1.73 m² represents normal kidney function for this patient's age, as normal GFR is approximately 130 mL/min/1.73 m² for men with a mean decline of 0.75 mL/min/year. 1

CKD Staging Context

• eGFR ≥60 mL/min/1.73 m² does NOT define CKD unless persistent kidney damage markers are present (albuminuria, hematuria, structural abnormalities, or pathological findings). 5
• If kidney damage markers exist, this would be CKD Stage 2 (eGFR 60-89 mL/min/1.73 m² PLUS kidney damage). 5
• Without kidney damage markers, this represents normal kidney function for age. 5

Clinical Significance

• No drug dosage adjustments are needed as eGFR is above the 60 mL/min/1.73 m² threshold where medication dose modifications typically begin. 2
• This eGFR level is NOT associated with increased CKD complications or cardiovascular risk that occurs below 60 mL/min/1.73 m². 2

Important Caveats

Serum creatinine alone should never be used to assess kidney function because it is affected by muscle mass, creatinine generation, tubular secretion, and extrarenal excretion independent of GFR. 2

Factors That May Affect Accuracy

• Recent exercise (within 24 hours), infection, fever, marked hyperglycemia, or hypertension can elevate creatinine independently of kidney damage and should prompt repeat testing in 3-6 months before establishing a definitive diagnosis. 6
• The enzymatic PAP method for creatinine assay is more specific than the Jaffé method, though hyperbilirubinemia can cause inaccurate creatinine measurements with colorimetric methods. 1, 2
• Extremes of muscle mass, obesity, or amputees may have inaccurate GFR estimates in non-steady-state conditions. 1

Next Steps for Complete Assessment

• Assess albuminuria using urine albumin-to-creatinine ratio (UACR) to complete risk stratification, as albuminuria independently predicts CKD progression, cardiovascular events, and mortality at any eGFR level. 5, 6
• If UACR ≥30 mg/g is present, this patient would be classified as having CKD Stage 2 and require CKD-specific management including blood pressure control, ACEI/ARB therapy, and annual monitoring. 5
• Referral to nephrology is NOT indicated at this eGFR level unless progressive decline occurs or eGFR falls below 45 mL/min/1.73 m², particularly if associated with proteinuria. 1