Removing race coefficient from eGFR equation changes CKD stage for 28% of Black patients
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When the race coefficient was removed from the eGFR equation, 28.1% of Black patients were reclassified to a more severe chronic kidney disease stage, compared with when the coefficient was included in the equation.
“The study aimed to assess the impact of removing race adjustment when estimating glomerular filtration rate (kidney function) on patients’ classification and on the degree of kidney dysfunction,” Ibrahim A. Hashim, MSc, PhD, FIBMS, CSc, DABCC, FAACC, of the University of Texas Southwester Medical Center at Parkland Memorial Hospital, told Healio.
Hashim and colleagues examined 80,090 serum creatinine values from 56,676 adults (31.4% were Black; 67.5% were women; the median age was 51 years). Data were derived from electronic medical records during a 16-month period.
Researchers used the Chronic Kidney Disease Epidemiology Collaboration equation with and without a race coefficient to determine the eGFR of patients. Additionally, the 2012 Kidney Disease: Improving Global Outcomes guidelines were used to measure CKD stage.
Analyses revealed 50.8% of Black patients and 67.9% of patients who are not Black had stage 1 CKD.
“Given that these two cohorts are demographically similar, this shows a discrepancy in kidney function even before removing the race adjustment,” Hashim and colleagues wrote.
Once researchers removed the race coefficient from the equation, 28.1% of Black patients were reclassified to a more severe CKD stage; 39% of these patients were reclassified from stage 3A CKD to stage 3B CKD. Researchers noted that a stage 3B CKD classification would warrant clinical attention for nephrology referral, something that would have been missed if a patient were not reclassified.
Hashim told Healio that future research should assess the utility of more accurate biomarkers of kidney function, such as cystatin C, or the use of invasive dynamic tests, such as iohexol, in a high-risk patient population.
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Hashim IA, et al. Abstract A-029. Presented at: AACC Annual Scientific Meeting; July 24-28, 2022; Chicago.
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