A Race-Free eGFR Formula Could Improve Care for Patients With Kidney Disease

Key Takeaways:

• The National Kidney Foundation and a coalition of US pharmacies are encouraging physicians to transition to the 2021 CKD Epidemiology Collaboration (EPI) race-free estimated glomerular filtration rate (eGFR) formula when prescribing medication for patients with kidney disease.
• The current Cockcroft-Gault estimated creatinine clearance (eCrCL) equation is limited by its lack of diversity during development, inconsistent use of variables, and inaccurate calculations, all of which create significant gaps in care.
• This new race-free formula accounts for patient surface area and delivers more precise results. Successful implementation could improve medication-related decision-making and provide more equitable, trusted care for patients with chronic kidney disease (CKD).

The National Kidney Foundation is collaborating with a coalition of US pharmacies to promote a nationwide transition from the traditional Cockcroft-Gault eCrCL equation to a race-free eGFR test when it comes to prescribing medications for patients with CKD.

Cockcroft-Gault vs Race-Free Equations

The Cockcroft-Gault equation has been in practice for nearly 50 years, but it was developed using data from white male patients. Additionally, the equation inconsistently factors patient body weight and has a history of inaccurate results. These limitations create significant gaps in care that are addressed in the new 2021 CKD-EPI race-free formula.

The biggest difference with the race-free eGFR equation is that it adjusts for body surface area when calculating medication doses. Furthermore, the formula is based on more recent clinical data and has achieved wide expert endorsement. According to the authors, “This approach more accurately predicts drug clearance, aligns kidney assessment across medical decisions, and reduces variability in clinical interpretation.”

Closing Gaps in CKD Care

Real-world adoption of the race-free eGFR formula will take time and will require deliberate, coordinated implementation strategies across the health care system. This growing movement toward race-free equations marks an important step forward in CKD care.

Using more accurate and consistent models will lead to more equitable care and better outcomes when it comes to medication decision-making for patients with kidney disease.

Reference

National Kidney Foundation and U.S. pharmacy organizations call for transition to race-free eGFR in medication decision-making. National Kidney Foundation. Published June 1, 2026. Accessed June 19, 2026. https://www.kidney.org/press-room/national-kidney-foundation-and-u-s-pharmacy-organizations-call-transition-to-race-free