{ "release_id": "f6f6f1b6f50379ed", "id": "cardio:egfr", "owner": "cardio", "kind": "biomarker", "slug": "egfr", "name": "Estimated glomerular filtration rate (eGFR)", "aliases": [ "eGFR", "Estimated GFR" ], "atlases": [ "cardio" ], "summary_plain": "A number on a kidney blood test report that estimates how well the kidneys filter waste. It is worked out from a blood test, usually creatinine, and it is used to find kidney disease, to see how serious it is and to follow it.", "summary_technical": "Estimate of glomerular filtration rate from serum creatinine, cystatin C or both, with age and sex. A 2021 paper developed equations that leave out race and found the creatinine and cystatin C equations more accurate than creatinine-only equations in validation data. eGFR ranges set who could enter FLOW, FIDELIO-DKD, DAPA-CKD and EMPA-KIDNEY, and eGFR declines are part of their kidney outcomes.", "editorial_state": "draft", "last_substantive_edit": "2026-10-14", "last_evidence_check": null, "next_review_due": null, "identifiers": [ { "scheme": "mesh", "value": "D005919", "normalized_value": "D005919", "match": "broad", "version": "2026", "label": null, "from_source": false } ], "navigation": { "cardio": { "system": [ "kidneys" ], "condition-area": [ "kidney-connections" ] } }, "payload": { "measure": "An estimate of the rate at which the kidneys filter blood, per 1.73 m2 of body surface area, calculated from a blood test.", "assay_context": "Usually calculated from a creatinine blood test; some people have cystatin C measured instead. A measured GFR (mGFR) test is used where an estimate is unreliable.", "interpretation_claims": [ "cardio:claim-egfr-use", "cardio:claim-egfr-race-free-equations" ] }, "content_digest": "9952d94b5a241753bb7b37bc66b6d67c5e004ba416a73cca4c8615b4800a93ad", "review": { "content_digest": "9952d94b5a241753bb7b37bc66b6d67c5e004ba416a73cca4c8615b4800a93ad", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "f6f6f1b6f50379ed", "id": "cardio:claim-egfr-race-free-equations", "owner": "cardio", "subject_entity_id": "cardio:egfr", "category": "descriptive", "statement": "A 2021 paper in the New England Journal of Medicine developed new eGFR equations that leave out race. The authors say race in eGFR equations is a social and not a biologic construct. In the validation data (12 studies, 4050 participants, 14.3% Black), 85% or more of the eGFRs for Black and non-Black participants were within 30% of measured GFR for all equations. The new equations that combine creatinine and cystatin C were more accurate than the new creatinine equations, with smaller differences between race groups.", "context": { "id": "cardio:ctx-egfr-equations-development-and-validation-studies", "label": "Participants in the studies used to develop and validate race-free eGFR equations", "recipient": "unknown", "population": "Participants in 10 studies (8254 participants, 31.5 percent Black) used to develop the creatinine equations, 13 studies (5352 participants, 39.7 percent Black) used for the creatinine and cystatin C equations, and 12 studies (4050 participants, 14.3 percent Black) used for validation.", "care_setting": "Not stated in the abstract", "geography": "Not stated in the abstract; the paper also projects CKD prevalence in a sample of U.S. adults", "life_stage_note": "Not stated in the abstract", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (pooled development and validation datasets)", "eligibility": { "inclusion": [], "exclusion": [] } }, "evidence_stage": "observational", "certainty": "not_assessed", "certainty_method": null, "limitations": "Only the PubMed abstract was read. The abstract does not state the ages of the participants. The abstract also reports that the new creatinine equations, but not the new creatinine and cystatin C equations, raised the estimated prevalence of chronic kidney disease among Black adults in a projection for U.S. adults. The study was funded by NIDDK (abstract).", "editorial_state": "draft", "checked_at": "2026-10-14", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "context", "locator": "Abstract, BACKGROUND, sentence 2", "applicability_note": "Why race was removed from the equations.", "snapshot": { "id": "cardio:pubmed-34554658-2026-10-14", "retrieved_at": "2026-10-14T18:18:51Z", "content_hash": "0e7cbff49da3e69d4b8964180159afcc8043f754e444ad86e7ac79a46d0caeb1", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2102953", "source_type": "publication", "title": "New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race", "canonical_url": "https://doi.org/10.1056/NEJMoa2102953", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2102953", "normalized_value": "10.1056/nejmoa2102953", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "34554658", "normalized_value": "34554658", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC8822996", "normalized_value": "PMC8822996", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2021-11-04", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. 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The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } } ], "review": { "content_digest": "1ffc306c521581a4c23121b8fb24a24fc05209b074b1f3db31af736c167f6c73", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/cardio--claim-egfr-race-free-equations.json" }, { "release_id": "f6f6f1b6f50379ed", "id": "cardio:claim-egfr-use", "owner": "cardio", "subject_entity_id": "cardio:egfr", "category": "descriptive", "statement": "MedlinePlus says eGFR and mGFR tests are used to see if the kidneys are filtering waste at a healthy rate. An eGFR test is used to screen for kidney disease in people without symptoms, to help diagnose it in people who have symptoms, to help find out how serious kidney disease is, and to monitor people being treated for chronic kidney disease. The page says the provider can find eGFR by measuring creatinine levels, for example in a basic metabolic panel.", "context": { "id": "cardio:ctx-adults-with-or-at-risk-of-ckd-nih-pages", "label": "Adults with chronic kidney disease or at risk of it (NIDDK and MedlinePlus patient pages)", "recipient": "adult", "population": "Adults with chronic kidney disease, or at higher risk of it, for example because of diabetes or high blood pressure.", "care_setting": "Not stated; patient information pages", "geography": "Not stated; United States federal health agencies", "life_stage_note": "Adults", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (descriptive page)", "eligibility": { "inclusion": [], "exclusion": [] } }, "evidence_stage": "not_applicable", "certainty": "not_assessed", "certainty_method": null, "limitations": "A patient-information page from the National Library of Medicine. The passages read give no eGFR values or stage thresholds, so this atlas gives none.", "editorial_state": "draft", "checked_at": "2026-10-14", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "What is it used for?, para 1", "applicability_note": "What the tests are for.", "snapshot": { "id": "cardio:medlineplus-gfr-test-2026-10-14", "retrieved_at": "2026-10-14T18:30:06Z", "content_hash": "159b2f634d33619df9137836f16dbbbd8883c335db915bd000da1658fc944446", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:medlineplus-gfr-test", "source_type": "webpage", "title": "MedlinePlus medical test: Glomerular Filtration Rate (GFR) Test", "canonical_url": "https://medlineplus.gov/lab-tests/glomerular-filtration-rate-gfr-test/", "identifiers": [], "publication_date": null, "publisher": "U.S. National Library of Medicine (MedlinePlus)", "edition": "MedlinePlus page fetched 2026-10-14; the page footer says last updated September 30, 2026.", "reuse_basis": "The MedlinePlus page on using its content (fetched 2026-10-14 as ch-medlineplus-usingcontent.html, sha256 31267ce9db01, hash only) says works produced by the federal government are not copyrighted, and lists summaries on health topic pages and medical test information as public domain; A.D.A.M. Medical Encyclopedia articles are copyrighted, and this atlas cites none. Please acknowledge MedlinePlus, National Library of Medicine, as the source. The raw page is committed at research/snapshots/ch-medlineplus-gfr-test.html.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "What is it used for?, list", "applicability_note": "The listed uses of an eGFR test.", "snapshot": { "id": "cardio:medlineplus-gfr-test-2026-10-14", "retrieved_at": "2026-10-14T18:30:06Z", "content_hash": "159b2f634d33619df9137836f16dbbbd8883c335db915bd000da1658fc944446", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:medlineplus-gfr-test", "source_type": "webpage", "title": "MedlinePlus medical test: Glomerular Filtration Rate (GFR) Test", "canonical_url": "https://medlineplus.gov/lab-tests/glomerular-filtration-rate-gfr-test/", "identifiers": [], "publication_date": null, "publisher": "U.S. National Library of Medicine (MedlinePlus)", "edition": "MedlinePlus page fetched 2026-10-14; the page footer says last updated September 30, 2026.", "reuse_basis": "The MedlinePlus page on using its content (fetched 2026-10-14 as ch-medlineplus-usingcontent.html, sha256 31267ce9db01, hash only) says works produced by the federal government are not copyrighted, and lists summaries on health topic pages and medical test information as public domain; A.D.A.M. Medical Encyclopedia articles are copyrighted, and this atlas cites none. Please acknowledge MedlinePlus, National Library of Medicine, as the source. The raw page is committed at research/snapshots/ch-medlineplus-gfr-test.html.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Why do I need a GFR test?, para 1", "applicability_note": "eGFR is found from creatinine levels.", "snapshot": { "id": "cardio:medlineplus-gfr-test-2026-10-14", "retrieved_at": "2026-10-14T18:30:06Z", "content_hash": "159b2f634d33619df9137836f16dbbbd8883c335db915bd000da1658fc944446", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:medlineplus-gfr-test", "source_type": "webpage", "title": "MedlinePlus medical test: Glomerular Filtration Rate (GFR) Test", "canonical_url": "https://medlineplus.gov/lab-tests/glomerular-filtration-rate-gfr-test/", "identifiers": [], "publication_date": null, "publisher": "U.S. National Library of Medicine (MedlinePlus)", "edition": "MedlinePlus page fetched 2026-10-14; the page footer says last updated September 30, 2026.", "reuse_basis": "The MedlinePlus page on using its content (fetched 2026-10-14 as ch-medlineplus-usingcontent.html, sha256 31267ce9db01, hash only) says works produced by the federal government are not copyrighted, and lists summaries on health topic pages and medical test information as public domain; A.D.A.M. Medical Encyclopedia articles are copyrighted, and this atlas cites none. Please acknowledge MedlinePlus, National Library of Medicine, as the source. The raw page is committed at research/snapshots/ch-medlineplus-gfr-test.html.", "public_text": "quote" } } ], "review": { "content_digest": "3693bc41b529a2481c61153763bbf745cefd90e3858d657d9aedafb2a6beb99a", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/cardio--claim-egfr-use.json" } ], "decisions": [], "milestones": [], "relationships": { "outgoing": [ { "predicate": "evaluated_for", "label": "Used to screen for, stage and follow chronic kidney disease", "clinical_claim_not_fact": true, "family": "clinical", "other_entity_id": "cardio:chronic-kidney-disease", "other_entity_in_atlas": true, "claim_id": "cardio:claim-egfr-use", "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null } ], "incoming": [ { "predicate": "related_to", "label": "Related to", "clinical_claim_not_fact": false, "family": "navigation", "other_entity_id": "core:medlineplus", "other_entity_in_atlas": true, "claim_id": null, "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "investigates", "label": "Investigated in", "clinical_claim_not_fact": false, "family": "sourced", "other_entity_id": "cardio:dapa-ckd", "other_entity_in_atlas": true, "claim_id": null, "evidence": { "snapshot_id": "cardio:ctgov-nct03036150-2026-10-14", "locator": "protocolSection.outcomesModule.primaryOutcomes[0].measure" }, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "investigates", "label": "Investigated in", "clinical_claim_not_fact": false, "family": "sourced", "other_entity_id": "cardio:empa-kidney", "other_entity_in_atlas": true, "claim_id": null, "evidence": { "snapshot_id": "cardio:ctgov-nct03594110-2026-10-14", "locator": "protocolSection.outcomesModule.primaryOutcomes[0].description" }, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "investigates", "label": "Investigated in", "clinical_claim_not_fact": false, "family": "sourced", "other_entity_id": "cardio:fidelio-dkd", "other_entity_in_atlas": true, "claim_id": null, "evidence": { "snapshot_id": "cardio:ctgov-nct02540993-2026-10-14", "locator": "protocolSection.outcomesModule.primaryOutcomes[0].measure" }, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "investigates", "label": "Investigated in", "clinical_claim_not_fact": false, "family": "sourced", "other_entity_id": "cardio:flow-trial", "other_entity_in_atlas": true, "claim_id": null, "evidence": { "snapshot_id": "cardio:ctgov-nct03819153-2026-10-14", "locator": "protocolSection.outcomesModule.primaryOutcomes[0].measure" }, "primary": false, "role": null, "valid_from": null, "valid_to": null } ] }, "page_path": "biomarkers/egfr/", "context_path": "api/v1/context/cardio--egfr.md" }