Modern medicine has long recognized inherent physiological distinctions across ethnicities, necessitating personalized healthcare strategies.
One notable distinction arises from the tendency of Black individuals to exhibit markedly elevated serum creatinine levels compared to their White counterparts, sometimes reaching up to six times higher levels. Thus, what might be deemed normal for a Black individual could signify end-stage kidney disease in a White individual.
In tracking the progression of kidney disease, physicians rely on an estimated glomerular filtration rate (eGFR) to assess the kidneys’ efficiency in eliminating excess creatinine from the body. Furthermore, the kidney transplant list prioritizes patients based on their eGFR, ensuring those with more severe conditions receive transplants first.
However, esteemed institutions have recently united to denounce this approach as racially biased, advocating for the removal of race-based constants from eGFR scores. The National Academies of Sciences, Engineering, and Medicine, along with the American Society of Nephrology (ASN), the National Kidney Foundation (NKF), and the Organ Procurement and Transplantation Network (OTPN), are among these institutions.
“The new formula will deem more than 10 million nonblack patients to have either less severe chronic kidney disease or no disease at all — while deeming more than 1 million black patients to have more severe disease or to have disease for the first time,” a team of researchers publishing in the Journal of the American Society of Nephrology wrote.
“Because the new formula doesn’t include the necessary racial adjustments, however, these reclassifications misrepresent reality,” they added.
The eGFR incorporates ethnicity-based adjustments to accommodate diverse normal creatinine levels, ensuring priority for transplant listing for individuals in critical condition while preventing unnecessary transplants for those less severely ill.
As a consequence, a completely healthy Black individual can now receive a kidney transplant ahead of a dying White individual. Since January 1, 2023, 6,103 Black individuals have surpassed White individuals with more severe kidney disease on the list, resulting in a 1.7-year increase in wait time for sicker kidney patients.
