Why Has Race Been Used to Calculate an eGFR?
More Programs and Publications Featuring Dr. Kyle Riding
In this program:
Race has been used as a calculation factor for estimated glomerular filtration rate (eGFR). Watch as medical laboratory scientist Dr. Kyle Riding explains why a race correction factor was created and what patients of African descent can do to ensure the best kidney health monitoring.
Transcript
Leo Hesse:
Now, Dr. Riding, you may be aware of the fact that race has been used to calculate eGFR, and it's been a subject of debate as it does not account for the diversity within communities of color. Now, can you give us an update on this and what questions patients of color should be asking about their results?
Dr. Kyle Riding:
Absolutely, this is actually a huge topic in laboratory medicine, and I'm so glad it's being asked right now, so when we first...
Not we, I didn't create the calculation, but when the calculation for the estimated glomerular filtration rate was made, one of the things they did was add a race correction factor, where individuals who were designated as African Americans have this correction factor built into the equation, while others did not have that correction factor built in. The researchers who did this correction factor did so with noble intent, there was no malicious intent in this. Through their study, they noticed that their population of individuals of African descent had an alteration between that estimated glomerular-al filtration rate and the directly measured ability of the kidneys to filter the blood. Here's the problem though, the researchers didn't choose a sample population of individuals of African descent that truly represented that broader cohort, and because of that, we have a correction factor that actually creates some poorer outcomes for individuals who are African American or of African descent. So there is some argument out there that we should get rid of this correction factor, because it does create some poor outcomes in patients...here's what I'm going to advise any patient to do. If you see both an estimated glomerular filtration rate eGFR for African American or non-African American or African descent or non-African descent, and the values, one is normal and one is abnormal.
I'm going to advise you to ask your physician, “Hey, one of these calculations is saying I have kidneys that are unhealthy, and the other is telling me I have kidneys that are healthy. How are we going to track this, which of these two equations are we going to use, and what can we do about this now to assure that I don't become a statistic on an individual that had poor kidney health because of this race correction factor?” So if you see that and you are concerned and your results are borderline, call it out to your provider, say that you're concerned about how that correction factor was developed, and make sure that they're giving you a reasonable answer to which one they're going to monitor and how they're going to assure your health and wellness. And if they're not meeting your demands and you're still feeling uncomfortable, I will always encourage patients to seek a second opinion, particularly on the health of your kidneys because of how vital they are to your health and wellness.
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