Impact of the new, race-free {CKD}-{EPI} equation on prevalence and clinical outcomes of {CKD} in northeastern Italy: the {INCIPE} study

This study assesses the impact of adopting the new race-free CKD-EPI equation on the prevalence and clinical outcomes of chronic kidney disease (CKD) within a predominantly Caucasian, Mediterranean cohort from northeastern Italy, as part of the INCIPE study. The CKD-EPI equation, which estimates glomerular filtration rate (eGFR), was updated to exclude race as a factor, following recommendations by the NKF-ASN Task Force, yet its effects on diverse populations remain underexplored. Using data from a representative sample of 3,775 adults in the Veneto Region, this study evaluated CKD prevalence and reclassification under the new equation compared to the previous version. Results indicated a reduction in CKD prevalence from 12.5% with the old equation to 11.0% with the new one. Notably, 118 participants were reclassified to a lower CKD stage or as non-CKD. Mortality analysis revealed that individuals reclassified as non-CKD displayed mortality rates similar to those with confirmed CKD, suggesting that the older equation may more accurately reflect risk for this group. Survival analyses confirmed a higher mortality risk in reclassified individuals, supporting the value of both eGFR equations in capturing nuanced health outcomes. This study contributes to CKD diagnostic practices, showing the race-free equation lowers CKD prevalence estimates in Caucasian populations but may underestimate risks in specific subgroups, warranting further evaluation of eGFR equations across diverse demographics.