This level, clearly understood to warrant specialty evaluation in the pre-eGFR days, coincides with the putative “point of no return” of many renal diseases suggesting that some patients may in fact receive sub-optimal care due to such filtering. In contrast, self-referring patients do not seem to apply such filtering, seeking specialty evaluation even when creatinine has increased just above the range of normal values reported by the laboratory. This finding is no different from previous reports showing that non nephrologists will refer late, i.e. after creatinine is higher than 177 mmol/l, a pattern which may be due to limited awareness of the need for early specialty evaluation and care. Alternatively such late referrals can be due to perceptions of the nephrologist role as one of transitioning the patient with advanced CKD towards a plan for ESRD management when eGFR declines below 30 ml/min/ 1.73 m2. In that regards, automatic eGFR reporting, which has been shown to aid the identification of subtle renal impairment, increase the prescription rate of nephro-protective ACEis/ARBs and the probability of specialty referral, may be viewed as an important tool for the management of CKD patients by primary care practitioners. On the other hand, eGFR reporting may increase the number of inappropriate evaluations and the nephrologist workload, as patients are seen at higher levels of eGFR. Nevertheless, recent evaluations have shown that although consults increase, the proportion of inappropriate consults does not invariably go up, the reported eGFR does not influence the rate of consults among patients without CKD, and the additional workload is modest. Early nephrology referral has been associated with slower disease progression and a 45% reduction in the risk of death, and is thus an important aspect of a comprehensive CKD population health care program. Furthermore, patients referred late have inferior control of risk factors for CKD progression, CKD complications, uremic cardiomyopathy and worse patient survival when they reach dialysis. On the other hand, specialty referral has been shown to lead to higher rates of prescriptions for ACEis/ARBs, NSAID avoidance, stabilization or improvement in renal function decline CKD and improved survival among patients with consistent nephrology follow-up. Since eGFR reporting may be a valuable component for the optimization of pre-dialysis CKD care and it is currently not implemented on a large scale in the Greek health care system, we explored the utility of different estimating equations for either GFR or creatinine clearance. Assuming the CKD-Epi equation as the emerging gold standard, our analyses highlight potential pitfalls of the other methods including the imprecision of the MDRD at higher levels of eGFR, the large bias of the CG and the potential for misclassification at earlier CKD stages. This is particularly important from the HhAntag691 perspective of public health expenditure in Greece, as therapies targeting complications of CKD stages 3–5 are currently fully reimbursed without any patient copayment Hence accurate staging of CKD is important for both early identification and public health budget optimization, goals that can be attained by widespread adoption of the CKD-Epi equation in the GNHS.