{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:11:31Z","timestamp":1789056691010,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","funder":[{"name":"Instituto Nacional de Geriatr\u00eda"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Accurate eGFR is essential for identifying and managing CKD. The CKD Epidemiology Collaboration (CKD-EPI) 2021 equation removed the race coefficient from the 2009 version, but its effect in Mexican populations remains unclear. Here, we compared eGFR category prevalence, and predictive performance between the CKD-EPI 2009 and 2021 creatinine-based eGFR equations, as well as the prognostic relevance of reclassification in eGFR categories using the 2021 equation in Mexicans. We evaluated 25,110 adults who were at least aged 20 years from the 2016\u20132023 cycles of the Mexican National Health and Nutrition Survey to estimate national low eGFR and eGFR category prevalence using both equations. We also assessed 5-year and 10-year risk of all-cause, cardiovascular, and kidney-related mortality in 142,884 adults from the Mexico City Prospective Study using Cox proportional hazards and Fine and Gray regression models. In Mexican National Health and Nutrition Survey 2023, prevalence of eGFR &lt;60 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      was lower with CKD-EPI 2021 (3%; 95% confidence interval [CI], 2% to 4%) compared with the 2009 equation (4%; 95% CI, 2% to 5%). Use of the 2021 equation resulted in upward eGFR reclassification in 7% (95% CI, 4% to 9%) of adults 20 years or older, particularly among older adults and those with hypertension or diabetes, yielding a reduction in 486,532 adults identified with eGFR &lt;60 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      compared with the 2009 equation. In Mexico City Prospective Study, despite both equations showing similar C-statistics, the 2021 equation reclassified 8.3% of participants to higher eGFR categories, and reclassification was associated with lower risk of 5-year and 10-year all-cause, cardiovascular, and kidney-related mortality, particularly for participants reclassified upward from G3a to G5 categories. The CKD-EPI 2021 equation yields lower prevalence of low eGFR but leads to prognostically relevant eGFR category reclassification compared with the 2009 equation. Our findings support the implementation of the 2021 equation for population health monitoring in Mexico without compromising prognostic utility.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000000933","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T17:00:26Z","timestamp":1765558826000},"page":"1645-1656","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Low eGFR Prevalence and Prediction for Mortality Using 2009 and 2021 CKD Epidemiology Collaboration Equations in Mexican Adults"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6899-246X","authenticated-orcid":false,"given":"Daniel","family":"Ram\u00edrez-Garc\u00eda","sequence":"first","affiliation":[{"name":"Research Division, Instituto Nacional de Geriatr\u00eda, Mexico City, Mexico"},{"name":"Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5627-8851","authenticated-orcid":false,"given":"Carlos A.","family":"Ferm\u00edn-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Research Division, Instituto Nacional de Geriatr\u00eda, Mexico City, Mexico"},{"name":"MD\/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"S\u00e1nchez Castro","sequence":"additional","affiliation":[{"name":"Research Division, Instituto Nacional de Geriatr\u00eda, Mexico City, Mexico"},{"name":"Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda Guadalupe","family":"Cortez-Flores","sequence":"additional","affiliation":[{"name":"Department of Nephrology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9774-1210","authenticated-orcid":false,"given":"Jer\u00f3nimo","family":"Perezalonso Espinosa","sequence":"additional","affiliation":[{"name":"Research Division, Instituto Nacional de Geriatr\u00eda, Mexico City, Mexico"},{"name":"MD\/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"D\u00edaz-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Research Division, Instituto Nacional de Geriatr\u00eda, Mexico City, Mexico"},{"name":"MD\/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karime Berenice","family":"Carrillo-Herrera","sequence":"additional","affiliation":[{"name":"Research Division, Instituto Nacional de Geriatr\u00eda, Mexico City, Mexico"},{"name":"MD\/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4738-7593","authenticated-orcid":false,"given":"Leslie Alitzel","family":"Cabrera-Quintana","sequence":"additional","affiliation":[{"name":"Research Division, Instituto Nacional de Geriatr\u00eda, Mexico City, Mexico"},{"name":"MD\/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6707-3317","authenticated-orcid":false,"given":"Jaime","family":"Berumen-Campos","sequence":"additional","affiliation":[{"name":"Experimental Research Unit, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0704-9507","authenticated-orcid":false,"given":"Pablo","family":"Kuri-Morales","sequence":"additional","affiliation":[{"name":"Instituto Tecnol\u00f3gico y de Estudios Superiores de Monterrey, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Tapia-Conyer","sequence":"additional","affiliation":[{"name":"Experimental Research Unit, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9278-4516","authenticated-orcid":false,"given":"Jacqueline A.","family":"Seiglie","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9390-3871","authenticated-orcid":false,"given":"Jesus","family":"Alegre-D\u00edaz","sequence":"additional","affiliation":[{"name":"Experimental Research Unit, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neftali Eduardo","family":"Antonio-Villa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Yaxmehen","family":"Bello-Chavolla","sequence":"additional","affiliation":[{"name":"Research Division, Instituto Nacional de Geriatr\u00eda, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"issue":"10225","key":"B1-20260910","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, regional, and national burden of chronic kidney disease, 1990\u20132017: a systematic analysis for the global burden of disease study 2017","volume":"395","author":"Bikbov","year":"2020","journal-title":"Lancet."},{"issue":"4S","key":"B2-20260910","first-page":"S117","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","year":"2024","journal-title":"Kidney 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Nephrol."},{"issue":"19","key":"B6-20260910","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New creatinine- and cystatin C\u2013based equations to estimate GFR without race","volume":"385","author":"Inker","year":"2021","journal-title":"N Engl J Med."},{"issue":"7984","key":"B7-20260910","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1038\/s41586-023-06560-0","article-title":"Mexican Biobank advances population and medical genomics of diverse ancestries","volume":"622","author":"Sohail","year":"2023","journal-title":"Nature."},{"issue":"1","key":"B8-20260910","doi-asserted-by":"crossref","first-page":"4123","DOI":"10.1038\/s41467-025-59351-8","article-title":"Genetic ancestry and population structure in the all of us research program cohort","volume":"16","author":"Sharma","year":"2025","journal-title":"Nat Commun."},{"issue":"10","key":"B9-20260910","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.2215\/CJN.02020215","article-title":"Prevalence and correlates of CKD in Hispanics\/Latinos in the United States","volume":"10","author":"Ricardo","year":"2015","journal-title":"Clin J Am Soc Nephrol."},{"issue":"6","key":"B10-20260910","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1111\/j.1523-1755.2004.66025.x","article-title":"Creatinine levels among Mexican Americans, Puerto Ricans, and Cuban Americans in the Hispanic Health and Nutrition Examination Survey","volume":"66","author":"Rodriguez","year":"2004","journal-title":"Kidney Int."},{"issue":"19","key":"B11-20260910","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1056\/NEJMoa2103753","article-title":"Race, genetic ancestry, and estimating kidney function in CKD","volume":"385","author":"Hsu","year":"2021","journal-title":"N Engl J Med."},{"issue":"5, 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Mex."},{"issue":"6, Nov-Dic","key":"B15-20260910","doi-asserted-by":"crossref","first-page":"813","DOI":"10.21149\/13348","article-title":"Metodolog\u00eda de la Encuesta Nacional de Salud y Nutrici\u00f3n 2021","volume":"63","author":"Romero Mart\u00ednez","year":"2021","journal-title":"Salud Publica Mex."},{"issue":"2","key":"B16-20260910","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1093\/ije\/dyl042","article-title":"Cohort profile: the Mexico City prospective study","volume":"35","author":"Tapia-Conyer","year":"2006","journal-title":"Int J Epidemiol."},{"issue":"20","key":"B17-20260910","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1056\/NEJMoa1605368","article-title":"Diabetes and cause-specific mortality in Mexico City","volume":"375","author":"Alegre-D\u00edaz","year":"2016","journal-title":"N Engl J Med."},{"issue":"9731","key":"B18-20260910","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/S0140-6736(10)60674-5","article-title":"Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis","volume":"375","author":"Matsushita","year":"2010","journal-title":"Lancet."},{"issue":"2","key":"B19-20260910","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/j.1365-2362.2011.02562.x","article-title":"Assessing the incremental value of diagnostic and prognostic markers: a review and illustration","volume":"42","author":"Steyerberg","year":"2012","journal-title":"Eur J Clin Invest."},{"issue":"1","key":"B20-20260910","doi-asserted-by":"crossref","first-page":"105","DOI":"10.7326\/M22-0844","article-title":"Assessing performance and clinical usefulness in prediction models with survival outcomes: practical guidance for Cox proportional hazards 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An\u00e1lisis de datos basado en el estudio Global Burden of Disease 2021","volume":"159","author":"Argaiz","year":"2023","journal-title":"Gac Med Mex."},{"issue":"3","key":"B24-20260910","doi-asserted-by":"crossref","first-page":"e035285","DOI":"10.1136\/bmjopen-2019-035285","article-title":"Overview of the burden of chronic kidney disease in Mexico: secondary data analysis based on the global burden of disease study 2017","volume":"10","author":"Agudelo-Botero","year":"2020","journal-title":"BMJ Open."},{"issue":"4","key":"B25-20260910","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1093\/ckj\/sfaa229","article-title":"High prevalence of end-stage renal disease of unknown origin in Aguascalientes Mexico: role of the registry of chronic kidney disease and renal biopsy in its approach and future directions","volume":"14","author":"Gutierrez-Pe\u00f1a","year":"2021","journal-title":"Clin Kidney J."},{"issue":"6","key":"B26-20260910","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1093\/ndt\/gfaa041","article-title":"Decreased kidney function and agricultural work: a cross-sectional study in middle-aged adults from Tierra Blanca, Mexico","volume":"36","author":"Aguilar-Ramirez","year":"2021","journal-title":"Nephrol Dial Transplant."},{"key":"B27-20260910","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1111\/j.1523-1755.2005.09702.x","article-title":"Prevalence of chronic kidney disease in an urban Mexican population","volume":"97","author":"Amato","year":"2005","journal-title":"Kidney Int Suppl."},{"key":"B28-20260910","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1038\/ki.2009.540","article-title":"Prevalence of chronic kidney disease in the kidney early evaluation program (KEEP) M\u00e9xico and comparison with KEEP US","volume":"116","author":"Obrador","year":"2010","journal-title":"Kidney Int Suppl."},{"issue":"1","key":"B29-20260910","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/ndt\/gfac197","article-title":"Removing race from the CKD-EPI equation and its impact on prognosis in a predominantly White European population","volume":"38","author":"Fu","year":"2023","journal-title":"Nephrol Dial Transplant."},{"issue":"3","key":"B30-20260910","doi-asserted-by":"crossref","first-page":"426","DOI":"10.2215\/CJN.14491121","article-title":"Effect of the refitted race-free eGFR formula on the CKD prevalence and mortality in the Danish population","volume":"17","author":"Vestergaard","year":"2022","journal-title":"Clin J Am Soc Nephrol."},{"issue":"2","key":"B31-20260910","doi-asserted-by":"crossref","first-page":"283","DOI":"10.2215\/CJN.10000721","article-title":"Effects of the 2021 CKD-EPI creatinine eGFR equation among a national US veteran cohort","volume":"17","author":"Gregg","year":"2022","journal-title":"Clin J Am Soc Nephrol."},{"issue":"10","key":"B33-20260910","doi-asserted-by":"crossref","first-page":"2749","DOI":"10.1681\/ASN.2007020199","article-title":"Evaluation of the modification of diet in renal disease study equation in a large diverse population","volume":"18","author":"Stevens","year":"2007","journal-title":"J Am Soc Nephrol."}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000000933","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:00:47Z","timestamp":1789056047000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000000933"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.0000000933","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}