Clinical chemistry organization, NKF release guidance on racial and gender gaps in CKD
Click Here to Manage Email Alerts
Key takeaways:
- Laboratories should implement the race-neutral 2021 Chronic Kidney Disease Epidemiology Collaboration creatinine-based eGFR equation.
- Interventions to eliminate disparities in kidney care should be funded.
The American Association for Clinical Chemistry and National Kidney Foundation have released new guidelines to reduce racial and gender gaps for patients with chronic kidney disease.
The joint American Association for Clinical Chemistry (AACC)/NKF Guidance Document on Improving Equity in Chronic Kidney Disease Care aims to provide health care professionals with recommendations to improve equity in kidney health. It builds on progress from a 2021 NKF and American Society of Nephrology task force that presented new equations for determining eGFR that does not disproportionately affect any one group of patients based on race.
“Race and ethnicity are imprecise, nebulously defined systems of classification as they pertain to genetic ancestry, physiological characteristics and socioeconomic status, and should not be used to classify individuals into distinct biological categories,” Christina C. Pierre, PhD, DABCC, and Mark A. Marzinke, PhD, lead authors of the guidance document, said in a press release.
Recommendations in the guidance include integrating race-free equations into laboratory information systems, as well as notifying providers of the changes. It asks clinical laboratory workers to participate in multidisciplinary teams to help reduce disparities in CKD care and improve disease detection in high-risk populations.
In addition to standardizing biomarker testing and reporting for diverse racial groups, the guidance also provides advice to improve disease management in gender-diverse patients.
The full recommendations are summarized below:
- All laboratories should implement the race-neutral 2021 Chronic Kidney Disease Epidemiology Collaboration creatinine-based eGFR equation;
- National efforts should be undertaken to facilitate increased, routine and timely use of cystatin C in populations who have or are at risk for CKD; and
- Research should explore GFR estimation with new endogenous filtration markers, and interventions to eliminate disparities in kidney care should be funded.
“A complex interplay of biological and social factors influence racial and ethnic health care disparities,” the authors wrote in the guidance. “A framework for understanding the nuances and potential harms of utilizing race as a biological classifier in eGFR [as well as other poor practices] is provided and details evidence-based, actionable measures that clinical laboratorians can take to improve equity in kidney health.”
The full guidance document is available here.
Reference:
- AACC/NKF Guidance Document on Improving Equity in Chronic Kidney Disease Care. https://www.aacc.org/science-and-research/aacc-academy-guidance/improving-equity-in-chronic-kidney-disease-care. Published June 28, 2023. Accessed June 29, 2023.
Read more about
Click Here to Manage Email Alerts