*Purpose: New estimated glomerular filtration rate (eGFR) equations using serum creatinine (Cr) and/or cystatin C (CysC) have been derived to eliminate adjustment by perceived Black ancestry. We sought to analyze the performance of newer eGFR equations in Black living kidney donor (LD) candidates.

*Methods: Black LD candidates (n=64) who had measured iothalamate (i)GFR between 1/2015 and 10/2021 were included, and eGFR was calculated using race adjusted (Cr2009, Cr-CysC2012) and race unadjusted (Cr2021, Cr-CysC2021) CKD-EPI equations. Bias (eGFR-iGFR) and accuracy (percent within 30% of iGFR) were calculated.

*Results: Mean age at LD evaluation was 41±12 yrs, and 45% were male. Mean iGFR was 105±23 ml/min/1.73m². Results are shown in the Table. CKD-EPICr2021 eGFR showed a greater negative bias, and underestimated iGFR to a level <80 ml/min/1.73m² in 11% with iGFR ≥ 80. Alternatively, the CKD-EPICr-CysC2021 equation showed less bias and high accuracy in the absence of correction for Black ancestry. In donor candidates with iGFR ≥ 80 ml/min/1.73m², none were estimated below 80 by the CKD-EPICr-CysC2021 equation.

*Conclusions: The CKD-EPICr2021 equation appears to underestimate true GFR in Black LD candidates, with the potential to exclude some for falsely low eGFR. Alternatively, the recently recalibrated CKD-EPICr-CysC2021 equation appears to perform well in Black LD candidates, without negative bias or underestimation.

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