Academic medical center to eliminate race from eGFR calculations

Nov. 24, 2021

The University of Maryland Medicine has announced that it will end the use of a long-standing clinical standard that factors a patient’s race into the diagnosis of chronic kidney disease (CKD).

Clinicians use a metric called the estimated glomerular filtration rate, or eGFR, to measure kidney function. One equation commonly used to calculate eGFR, known as the CKD-EPI equation, includes an adjustment for race, resulting in a higher value for Black patients.

The higher value in this calculation often overestimates the health of Black patients’ kidneys, which can lead to delayed referral for specialty care. By one estimate, approximately 720,000 Black Americans might be treated earlier for kidney disease if race were removed from the calculations of kidney function, the university said.

Following a report last year in the New England Journal of Medicine, the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) formed a joint task force to review the use of race in eGFR calculations. In September, the group endorsed a new calculation without the race coefficient.

By late January, the University of Maryland Medical System (UMMS), including its flagship academic hospital, the University of Maryland Medical Center (UMMC), will transition to a new standard of evaluating kidney function, eliminating whether a patient is “African American or non-African American” as a factor. The move follows a review by University from Maryland School of Medicine (UMSOM) clinicians and scientists of recently released recommendations from professional societies.

Nationally, Black adults are three times more likely to suffer from kidney failure — making up roughly a third of U.S. dialysis patients, while comprising only 13% of the population, the university said.

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