Evaluating the Impact and Rationale of Race-Specific Estimations of Kidney Function: Estimations from U.S. NHANES, 2015-2018

Genetic ancestry in precision medicine is reshaping the race debate

“…For example, the usage of race corrections in estimated glomerular filtration rate (eGFR) equation to predict risk of end-stage kidney disease has been effectively challenged. Recent research demonstrates that race adjustments do not improve the accuracy of the eGFR test and that they may in fact disadvantage patient groups ( 36 , 37 ). Corrections that mistake race for a biological category in this case may undermine the proportion of Black patients who meet the diagnostic threshold for kidney disease ( 37 ).…”

“…Recent research demonstrates that race adjustments do not improve the accuracy of the eGFR test and that they may in fact disadvantage patient groups ( 36 , 37 ). Corrections that mistake race for a biological category in this case may undermine the proportion of Black patients who meet the diagnostic threshold for kidney disease ( 37 ). Additionally, calibration for race as a biological unit shifts risk estimates for Black patients to a higher risk category, consequently shifting all non-Black patients to lower risk groups, which may not necessarily be accurate ( 36 ).…”

Improving Cancer Care for Patients With CKD: The Need for Changes in Clinical Trials

“…61 A point of recent controversy is that the CKD-EPI equation incorporates race (Black vs. non-Black) as a variable and the appropriateness of this has been questioned as race is a social and not a biological construct. 62 Nevertheless, using the current CKD-EPI formula without race as a variable results in lower eGFR values for Black individuals 63 and runs the risk of 2 potentials problems as follows: (i) Black patients would not be offered certain chemotherapies due to a having a lower eGFR and (ii) underdosing of drugs in Black patients. Measuring GFR would solve this issue, but is not practically feasible.…”

Artificial intelligence in medicine: Overcoming or recapitulating structural challenges to improving patient care?

“… 15 , 16 It has been estimated that race-based adjustments to equations used to calculate estimated glomerular filtration rate (eGFR) levels for determining the severity of kidney disease alone results in the under-treatment of 3.3 million Black Americans who, without these corrections, would be more likely to receive earlier treatment for a range of complicating conditions. 17 …”