What is eGFR and Why Does It Matter?
The estimated Glomerular Filtration Rate (eGFR) is the best overall index of kidney function and is used to diagnose, stage, and monitor chronic kidney disease (CKD). GFR measures how much blood the kidneys filter per minute per 1.73 m² of body surface area. The CKD-EPI 2021 equation uses serum creatinine, age, and sex to estimate GFR without a race variable, making it the current standard recommended by the American Society of Nephrology and NKF. A declining eGFR over time is a key indicator of kidney disease progression and guides treatment decisions from lifestyle modification to dialysis planning.
Frequently Asked Questions
What is a normal eGFR?
An eGFR of 60 or higher is generally considered normal. eGFR above 90 is Stage G1 (Normal or High). Between 60–89 is G2 (Mildly Decreased). Below 60 for 3 months or more indicates chronic kidney disease.
Can eGFR be improved?
Yes, especially in early stages. Controlling blood pressure (target below 130/80), managing blood sugar in diabetics, reducing protein intake if advised, stopping NSAIDs, avoiding nephrotoxic medications, and quitting smoking can slow or sometimes partially reverse CKD progression.
Why does the CKD-EPI 2021 equation not include race?
The 2021 update removed the race coefficient from the original 2009 equation after research showed it led to underestimation of CKD in Black patients and could delay diagnosis and treatment. The race-free version performs comparably across diverse populations.