Clinical Implications of Removing Race From Estimates of Kidney Function

Abstract

This study uses NHANES data to compare estimated glomerular filtration rate from serum creatinine (eGFRcr) values calculated with vs without race as a variable, and to estimate the number of patients for whom nephrologist referrals and drug and renal replacement recommendations would change as a result according to KDIGO guidelines and Medicare benefit policies.

Figure.. Changes in Reported eGFR for Black Adults Following Removal of Race From eGFRcr

All Black adults would experience a decrease in reported estimated glomerular filtration rate (eGFR) of 13.7% (computed from the Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI]) race coefficient as 1 − 1/1.159). Median eGFR was 102.9 mL/min/1.73 m² with race and 88.8 mL/min/1.73 m² without race; the median eGFR change was −14.1 mL/min/1.73 m². The 25th percentile for the change in eGFR was −16.5 mL/min/1.73 m², and the 75th percentile for the change in eGFR was −11.5 mL/min/1.73 m². Data are from the 2001-2018 National Health and Nutrition Examination Survey (NHANES). eGFRcr indicates estimated glomerular filtration rate from serum creatinine.