![]() In order to qualify for a kidney transplant, a patient’s eGFR score has to be low enough to be considered end-stage kidney disease. Ten years later, a larger study led to the development of a more accurate eGFR equation called the chronic kidney disease epidemiology collaboration, or CKD-EPI-but it still contains a correction factor for Black patients. To prevent these supposedly elevated creatinine levels from skewing test results, researchers multiplied Black people’s eGFR scores by a factor of 1.2. But instead the study assumed that Black individuals had higher muscle mass, and thus higher creatinine, than white ones. This could be explained by the fact that a higher proportion of Black study participants may have already had end-stage kidney disease. Researchers noticed that Black participants had, on average, higher creatinine than white ones. The first equation to easily calculate eGFR (without the extra step of collecting and analyzing patients’ urine), was developed through a 1999 study with 1,628 participants. Perfectly healthy kidneys get a score above 60, while failing ones have scores below 15. (Because failing kidneys have a harder time filtering out creatinine, a high level indicates that the renal system is having problems.) Physicians use an equation to combine this information into an eGFR score. To determine kidney health, doctors first measure factors such as the level of creatinine, a by-product of muscle breakdown, in the blood. This summer the University of Washington School of Medicine announced that its medical centers would no longer use race in a measure of kidney function called the estimated glomerular filtration rate, or eGFR. Now students are working to change these practices, with some successful results. Today this ideology continues in diagnostic algorithms and practice guidelines that are adjusted based on patients’ race-and often lead to further inequities in the health care of nonwhite patients. ![]() Medicine has a long history of erroneous beliefs about biological differences between races. ![]()
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