Created Equal: The end of race-based kidney testing

Since the late ’90s, doctors have included race in equations used to estimate kidney function. 

Known as the estimated glomerular filtration rate (eGFR), the once widely-used equation evaluates factors including age, sex, race and/or body weight to detect and manage various kidney diseases. However, the test often overestimated how well Black people’s kidneys were functioning — making them appear healthier than they actually were and resulting in delayed diagnoses of organ failure and proper evaluation for transplants.

Now, that method is finally changing, and race is being removed from the equation. 

Dr. Neil Powe, chief of medicine at the Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and Trauma Center, joined Created Equal on Monday to discuss the problems with the eGFR equation and the changes being made in diagnosing kidney disease to improve equity in health care.

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Guest:

Dr. Neil Powe is a chief of medicine at Priscilla Chan and Mark  Zuckerberg of San Francisco General Hospital. Powe says due to findings of elevated levels of a substance called creatinine among African American populations, the individuals who developed the eGFR equation felt the need to incorporate that racial variable. However, he says, it has also created the potential for racial bias and further confusion.

“We still don’t understand the reasons for these differences in creatinine levels among African American and whites,” said Powe. “Furthermore, there were conjectures kind of at the time for speculations that may be the reason for the higher creatinine levels was due to muscle mass, and you can see how that would be pretty pejorative to say that African Americans always have more muscle mass than whites.”

Listen to Created Equal with host Stephen Henderson weekdays from 9-10 a.m. ET on 101.9 WDET and streaming on-demand.