Calculating eGFR for African Americans: Methodology Explained

Calculating eGFR for African Americans: Methodology Explained

In a significant move towards promoting fairness and accuracy in healthcare, the updated method for calculating the estimated Glomerular Filtration Rate (eGFR) was introduced in 2021. Known as the 2021 CKD-EPI equation, this new approach has made a notable change by excluding race as a variable in the equation [1][2].

Previously, eGFR equations like the 2009 CKD-EPI included race as a factor, which has been criticized for perpetuating racial bias and health disparities. The 2021 equation, however, aims for a more equitable estimation of kidney function across populations, improving clinical fairness [1][2].

The 2021 equation continues to incorporate creatinine, age, and sex for eGFR calculation but excludes race, making the formula more universally applicable without sacrificing accuracy. This shift reflects growing recognition that race is a social construct and that eGFR equations should not rely on race to avoid inequities in clinical decision-making.

Doctors typically use eGFR results to make important decisions such as diagnosing kidney disease, determining medication dosage, and deciding on a kidney disease treatment plan. An eGFR score of 60 or higher indicates normal kidney functioning, while a score under 60 may indicate kidney disease, and a score under 15 may indicate kidney failure. High creatine levels indicate worse kidney functioning [1].

People with chronic kidney disease (CKD) may experience symptoms such as swelling of the legs, feet, or ankles, chest pain, dry skin, itching or numbness, fatigue, headaches, increased or decreased urination, loss of appetite, and others [1]. CKD is often caused by diabetes, high blood pressure, heart disease, and a family history of kidney failure. African American people are three times more likely to develop kidney disease than non-African American people, and they make up over 35% of people in the U.S. who receive dialysis for kidney failure [2].

African American people are advised to be aware of their increased kidney disease risk and to check their blood sugar level, blood pressure, urine pressure, and kidney function regularly. Resources such as Black Doctors USA and the Black Health Matters Nephrologist Guide can help find Black doctors, including kidney specialists, in the local area [2].

The National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) formed a joint task force in 2020 to review the use of race and ethnicity in eGFR calculations. In September 2021, the task force recommended using the new 2021 CKD-EPI creatinine equation to calculate eGFR, which excludes ethnicity as a factor [1].

The NKF aims to continually assess and improve the accuracy of eGFR equations, and the shift towards the 2021 CKD-EPI equation is a significant step in this direction. The updated method not only improves prediction accuracy but also reduces racial bias, making it a more reliable tool for healthcare professionals in their quest to provide equitable care for all patients.

References: [1] National Kidney Foundation. (2021). 2021 CKD-EPI Creatinine Equation. Retrieved from https://www.kidney.org/professionals/kdoqi/2021/2021-ckd-epi-creatinine-equation [2] National Kidney Foundation. (2021). Kidney Disease in African Americans. Retrieved from https://www.kidney.org/atoz/content/kidney-disease-african-americans

1. The health sector has made strides in promoting fairness by revising the method for estimating Glomerular Filtration Rate (eGFR), introduced in 2021 as the 2021 CKD-EPI equation.
2. This equation is a notable change, eliminating race as a variable in the equation to avoid perpetuating racial bias and health disparities.
3. Previously, eGFR equations incorporated race as a factor, a practice that has been criticized for promoting inequities.
4. The updated equation continues to consider creatinine, age, and sex for eGFR calculation but excludes race, ensuring universally applicable accuracy.
5. Doctors rely on eGFR results for crucial decisions such as diagnosing kidney disease, determining medication dosage, and planning kidney disease treatment.
6. A normal eGFR score of 60 or higher suggests healthy kidney functioning, whereas a score under 60 may indicate kidney disease, and a score under 15 might signal kidney failure.
7. High creatine levels can indicate impaired kidney function.
8. Those with chronic kidney disease (CKD) often experience symptoms like swollen limbs, chest pain, dry skin, and fatigue.
9. CKD is often associated with diabetes, high blood pressure, heart disease, and a family history of kidney failure.
10. African American people are three times more likely to develop kidney disease compared to non-African American people.
11. African American people account for over 35% of people in the U.S. who resort to dialysis for kidney failure.
12. African American individuals are advised to monitor their kidney disease risk factors, including blood sugar levels, blood pressure, and kidney function.
13. Resources such as Black Doctors USA and the Black Health Matters Nephrologist Guide can help locate Black doctors, including kidney specialists, in the local area.
14. In 2020, the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) established a joint task force to examine the utilization of race and ethnicity in eGFR calculations.
15. In September 2021, the task force recommended using the new 2021 CKD-EPI creatinine equation, which forgoes ethnicity as a factor.
16. The NKF aims to consistently evaluate and enhance the accuracy of eGFR equations, and the transition toward the 2021 CKD-EPI equation is a significant step in this process.
17. The updated method not only enhances prediction accuracy but also reduces racial bias, making it a more reliable tool for healthcare professionals providing equitable care for all patients.
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