Updates to the NICE CKD Guideline: Ethnicity adjustment for kidney function testing removed A major change from the previous National Institute of Health and Care Executive (NICE) guideline is the removal of the recommendation to adjust for ethnicity when calculating the estimated glomerular filtration rate (eGFR) in people from black ethnic groups. We and colleagues welcome this change. More information can be found via our joint statement here.Measuring kidney function with eGFRA test called the eGFR (estimated glomerular filtration rate) is used to measure kidney function. The eGFR is calculated from the level of a chemical called creatinine in the blood. This is one of the most common tests to calculate patient’s stage of kidney disease. If a patient’s eGFR is low, their kidneys are not working as well as they should be. For people from black ethnic groups eGFRcreatinine was previously often calculated with an adjustment for their ethnicity. The eGFR test when estimating your kidney function is adapted for your height, weight and gender. Previously for people of black ethnicity, the kidney function estimate was also based on ethnicity, which may have meant that their kidney function was over-estimated. Removal of ethnicity from the NICE CKD guidelineThe recommendation to adjust for ethnicity has now been removed as it is no longer seen as valid or accurate. NICE highlight within their guideline that eGFRcreatinine may be less reliable in certain situations and provide the following examples: “acute kidney injury, pregnancy, oedematous states, muscle wasting disorders, and in adults who are malnourished, who have higher muscle mass or use protein supplements, or have had an amputation”; they also state that “eGFRcreatinine has not been well validated in certain ethnic groups, for example, black, Asian, and other minority ethnic groups with CKD living in the UK.”NICE recommend within the guideline that everyone’s kidney function estimate, regardless of ethnicity should be based on the individual and their muscle mass, unless or until further research shows something different. For more information visit the updated NICE chronic kidney disease guideline here You can also view The UK Kidney Association’s (UKKA) rationale and recommendations for implementation statement here.