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Race-Free Estimation of Kidney Function—Clearing the Path Toward Kidney Health Equity

Link [2022-06-22 11:48:47]

In this issue of JAMA, Gutiérrez et al explore how estimated racial differences in risk of kidney failure and mortality differ when race is eliminated from kidney function estimating equations and cystatin C is added. This important work follows vigorous recent national discourse, led by a National Kidney Foundation and American Society of Nephrology (NKF-ASN) Task Force, which in 2021 recommended the removal of Black race coefficients from kidney function estimating equations. The widely used Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, developed in 2009, and its predecessor the Modification of Diet in Renal Disease equation, developed in 1999, on which much of the national debate was focused, were developed to improve and standardize estimates of glomerular filtration rate for clinical practice and research. Black race coefficients were incorporated into these equations to account for systematic differences in serum creatinine values observed in data obtained from Black individuals when compared with others participating in research studies.