Impact of refitted race-free eGFR formula on obesity pharmacotherapy options

Academic Article


  • Objective: Recent changes to the Chronic Kidney Disease Epidemiology Collaboration estimated glomerular filtration rate (eGFR) formula (2021 CKD-EPI) removed race from the 2009 formula, increasing the number of Black people classified as having CKD, but these changes may impact eligibility and/or dosing for antiobesity medications. This study estimated the number of people with obesity nationwide who might have pharmacotherapy options impacted by the new formula. Methods: Using National Health and Nutrition Examination Survey (NHANES) cohort study data, the number of people eligible for antiobesity medication was estimated, and the number who would require a dosage reduction or would no longer be eligible for specific medications based on the new eGFR formula was also estimated. Results: Among 16,412,571 Black and 109,654,751 non-Black people eligible for antiobesity medication, 911,336 (6.1%) Black and 6,925,492 (6.6%) non-Black people had ≥CKD stage 3 by the 2009 CKD-EPI formula. Applying the 2021 CKD-EPI formula, 1,260,969 (8.5%) Black people and 4,989,919 (4.7%) non-Black people had ≥CKD stage 3. For medications requiring renal adjustment, the number of Black people who would require a lower dose or be precluded from using a medication increased by 24.7% to 50.2%. Conclusions: These findings highlight the importance of measuring—rather than estimating—GFR in Black people with CKD when considering many antiobesity pharmacotherapy options.
  • Published In

  • Obesity  Journal
  • Digital Object Identifier (doi)

    Author List

  • Orandi BJ; McLeod C; Reed RD; Kumar V; Igel LI; Aronne LJ; Cannon RM; Lewis CE; Locke JE
  • Start Page

  • 2204
  • End Page

  • 2212
  • Volume

  • 30
  • Issue

  • 11