Removing Race from eGFR calculations: Implications for Urologic Care

Area of Science:

• Nephrology
• Urology
• Health Equity

Background:

• Glomerular filtration rate (GFR) estimation equations are crucial for diagnosing and managing kidney disease.
• Urologists utilize these equations for critical decisions in cancer treatment, imaging, and post-surgical care.
• Current eGFR equations are recognized for their imprecision and controversial use of race as a factor.

Purpose of the Study:

• To examine the implications of removing race from eGFR equations in urologic practice.
• To inform urologists about potential consequences and alternative approaches.
• To address the impact on Black patients receiving urologic care.

Main Methods:

• Review of current eGFR equations and their clinical applications in urology.
• Analysis of the role of race in eGFR calculations.
• Discussion of the societal and clinical impact of race-based medicine.

Main Results:

• The use of race in eGFR equations is based on social, not biological, constructs.
• Recent discussions on healthcare racism highlight the need to re-evaluate race adjustments in eGFR.
• Changes to eGFR equations may disproportionately affect Black patients.

Conclusions:

• Urologists must understand the complexities of race adjustment in eGFR equations.
• Consideration of alternative eGFR formulas is necessary.
• Ensuring equitable care for Black patients undergoing urologic treatment is paramount.