New Calculator May Offer Earlier Detection of Chronic Kidney Disease Risk
A novel calculator leveraging age- and sex-specific eGFR percentiles could help clinicians identify patients at risk for chronic kidney disease (CKD) earlier than current methods allow, according to research published in Kidney International on February 13, 2026. The tool, developed by researchers at Karolinska Institute in Sweden, aims to address the current practice of often delaying intervention until a patient’s estimated glomerular filtration rate (eGFR) falls below 60 mL/min/1.73 m², by which point significant kidney function may already be lost.
More than 90% of adults in Stockholm exhibit normal kidney function, defined as an eGFR greater than 60 mL/min/1.73 m², but researchers emphasize that this value alone doesn’t fully capture risk. “This eGFR value could still indicate risks for kidney failure based on a patient’s age or sex,” the study authors wrote.
Currently, “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,” one expert explained. To address this, the researchers created a web-based calculator using data from over 1.1 million individuals aged 40 to 100 years (median age, 54 years) in Stockholm, encompassing more than 6.9 million serum creatinine eGFR tests collected between 2006 and 2021. The data, representing 80% of the region’s population, was stratified by age- and sex-specific eGFR percentiles.
The concept behind the calculator draws a parallel to pediatric growth charts. “Pediatricians use growth charts to show how a child’s height and weight compare with other children of the same age and sex,” explained Juan-Jesus Carrero, PhD, professor in the department of medical epidemiology and biostatistics at Karolinska Institute and lead author of the study. “We applied this same concept to kidney function.”
The calculator allows clinicians to compare a patient’s eGFR to that of peers with similar demographics. Researchers then used this data to identify individuals at increased risk for kidney failure or mortality, and to assess whether these high-risk patients were receiving guideline-recommended urine albumin testing.
Analysis revealed that patients with an eGFR below the 25th percentile for their age and sex faced a significantly elevated risk of developing kidney failure requiring dialysis or transplantation. For example, a 55-year-old woman with an eGFR of 80 mL/min/1.73 m² – typically considered normal – was found to be in approximately the 10th percentile for her age and sex, correlating with a threefold higher risk of needing dialysis. Furthermore, risks for mortality were also significantly higher in patients falling below the 25th percentile and above the 75th percentile.
Alarmingly, the study also highlighted a gap in monitoring. Albuminuria testing was performed on only 24% of patients with an eGFR of at least 60 mL/min/1.73 m² and 39% of those with an eGFR less than 60 mL/min/1.73 m² in the year following their initial assessment.
By integrating population-based eGFR estimates into clinical practice, clinicians may be able to proactively identify and intervene for patients at risk for CKD. “This approach is low cost and easy to implement,” Carrero stated. “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 [email protected].
Source: Yang Y, et al. Kidney Int. 2026;doi:10.1016/j.kint.2025.11.009.
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.
