Did you know that African American, Hispanic, Asian, and Native American people are affected by kidney diseases in disproportionate numbers? In particular, African American people are three times more likely than Non-Hispanic Whites to experience kidney failure. Unfortunately, the disparities do not stop there.

Racial disparities also extend to treatment modalities, including a patient’s access to transplantation. Even though African Americans represent 35% of the total number of people receiving dialysis in the United States, they are less likely to be identified as kidney transplant candidates when compared to Non-Hispanic Whites.

For that reason, the National Kidney Foundation (NKF) and the American Society of Nephrology  (ASN) announced the creation of a new task force to understand the implications of including race in kidney disease diagnostic methods.*

A potential flaw in the eGFR diagnostic method

The estimated glomerular filtration rate (eGFR) is a commonly used diagnostic method that has standardized the detection of and management of kidney disease and allows doctors to plan for dialysis and evaluate the need for transplantation. “The eGFR is derived by an equation that was initially generated by using serum creatinine measurement and included age, sex, race, and/or bodyweight to approximate directly measured kidney function,” according to the joint statement on the NKF website.

Unlike age, sex, and body weight, however, the NKF recognizes that race is a social construct, not biological, and including race oftentimes comes with a risk of inequitable and biased care. To ensure that clinicians provide the best, most equitable care for each patient, the new joint task force will examine the inclusion of race in the estimation of GFR and its implications for the diagnosis, and subsequent management of, patients with or at risk for kidney diseases.

Task force to tackle racial bias 

The goal of the task force, which aims to share its initial recommendations in 2020, is to ensure that racial bias does not affect the diagnosis and subsequent treatment of kidney diseases. 

“It is important that any change in eGFR reporting carefully consider the multiple social and clinical implications, be based on rigorous science, and be part of a national conversation about uniform reporting of eGFR across health care systems,” as written in the joint statement. The organizations also announced that they will keep laboratories, clinicians, and other health professionals informed of any potential long-term implications of removing race from the formula. 

The NFK and ASN explain that they are “committed to ensuring that GFR estimation equations provide an unbiased assessment of kidney function so that laboratories, clinicians, patients, and public health officials can make informed decisions to ensure equity and personalized care for patients with kidney diseases.”

*National Kidney Foundation. (2020, July 22). Establishing a Task Force to Reassess the Inclusion of Race in Kidney Diseases. https://www.kidney.org/news/establishing-task-force-to-reassess-inclusion-race-diagnosing-kidney-diseases