Is It Time For A Race Reckoning In Kidney Medicine?
As the U.S. grapples with the effects of systemic racism, some in the medical community are questioning whether the tools they use to assess patient health may be contributing to racial health disparities.
That debate is playing out most prominently in the world of kidney medicine. Black people are almost four times more likely to suffer from kidney failure than non-Hispanic whites. And once they get to that stage, Black patients spend months longer waiting for a kidney transplant than white patients.
Now, some doctors are asking whether a diagnostic formula most commonly used to assess the health of patients with chronic kidney disease may be unintentionally contributing to those poor outcomes — and reinforcing racist thinking.
The tool in question is a formula used to estimate GFR, or glomerular filtration rate. It's a measure of how fast a person's kidneys filter blood. Lower kidney filtration rates suggest worse kidney function.
The gold standard for measuring GFR is a burdensome process that involves urine collection over a 24-hour period as well as a blood sample. So instead, doctors and labs routinely estimate kidney function by measuring blood levels of creatinine, a waste product filtered by the kidneys, and then doing a calculation that also factors in the patient's age and sex.
But if a patient is African American, the
