February 13, 2026
3 min read
Key takeaways:
Table of Contents
- Patients with an eGFR below the 25th percentile of distribution for their age and sex had greater risks for kidney failure.
- Less than one-fourth of them received an albuminuria test in the adjacent year.
Identifying population-based eGFR distributions may help to identify patients at risk for developing chronic kidney disease earlier, according to study data published in Kidney International.
More than 90% of adults in Stockholm have normal kidney function with an eGFR greater than 60 mL/min/1.73 m², according to Juan–Jesus Carrero, PhD, professor in the department of medical epidemiology and biostatistics at Karolinska Institute in Sweden, and colleagues. However, this eGFR value could still indicate risks for kidney failure based on a patient’s age or sex, they wrote.
“In practice, albuminuria is seldom measured, meaning that we often wait until [a patient’s] eGFR falls below 60 mL/min/1.73 m² to take further action, even though a large amount of kidney function has already been lost by then,” Carrero told Healio.
To identify these eGFR distributions across different age groups and sex, the researchers developed a web-based calculator based on eGFR data from more than 1.1 million patients aged 40 to 100 years (median age, 54 years) in Stockholm. Their data captured 80% of the total population of the region and encompassed more than 6.9 million serum creatinine eGFR tests from 2006 to 2021 that were stratified by age- and sex-specific eGFR percentiles.
“Pediatricians use growth charts to show how a child’s height and weight compare with other children of the same age and sex,” Carrero said. “We applied this same concept to kidney function.”
Using the calculator, clinicians can compare an individual patient’s eGFR with other patients of the same age and sex. The researchers used these data to identify which patients were at greater risk for developing kidney failure or dying. They also evaluated whether patients at risk were undergoing guideline-recommended testing for urine albumin.
According to the data, median eGFR for patients aged 40 years was 104 mL/min/1.73 m² for men and 106 mL/min/1.73 m² for women, and the median eGFR for patients aged 100 years was 45 mL/min/1.73 m² for men and 50 mL/min/1.73 m² for women.
Results showed that patients with an eGFR below the 25th percentile of distribution for their age and sex had a significantly greater risk for developing kidney failure requiring dialysis or transplantation, according to the researchers.
“For instance, a 55-year-old woman with an eGFR of 80 mL/min/1.73 m² would usually be considered absolutely normal,” Carrero said. “However, for her age and sex, this value lies around the 10th percentile and is associated with a threefold higher risk of starting dialysis.”
In addition, the researchers found that risks for mortality were significantly higher in patients below the 25th percentile and above the 75th percentile.
Furthermore, the researchers found evidence that these patients were poorly monitored for other markers of kidney health: albuminuria testing occurred for 24% of patients with an eGFR of at least 60 mL/min/1.73 m² and 39% of patients with an eGFR less than 60 mL/min/1.73 m² in the adjacent year.
By comparing a patient’s eGFR data with population-based estimates, clinicians may be able to use this tool to identify and intervene for patients at risk for CKD earlier, according to the researchers.
“This approach is low cost and easy to implement,” Carrero said. “When a creatinine test is ordered, clinicians could automatically receive not only the eGFR value, but also its percentile for age and sex. This would provide a simple way to identify patients who appear ‘normal’ but are already deviating from expected kidney function and may benefit from earlier evaluation and prevention efforts. As such, this may be an effective tool for screening and primary prevention of CKD.”
For more information:
Juan–Jesus Carrero, PhD, can be reached at juan.jesus.carrero@ki.se.
Sources/Disclosures
Source:
Yang Y, et al. Kidney Int. 2026;doi:10.1016/j.kint.2025.11.009.
References:
Disclosures:
Carrero reports funding to Karolinska Institute by AstraZeneca, Boehringer Ingelheim, MSD, Novo Nordisk and Vifor Pharma, as well as honoraria for lectures by Fresenius Kabi and Laboratorios Columbia, all unrelated to this study. Please see the study for all other authors’ relevant financial disclosures.
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