Title: The case against race-based GFR

Abstract

The use of race in medicine implies that we are physiologically different based on our outward, physical characteristics. However, race is not based in genetics, nor in physiology, but is entirely a social construct based on characteristics, physical locations, and behavioral patterns. We have incorporated race into multiple clinical equations despite unclear evidence for doing so. We also recognize that the effects of racism and other social determinants of health, rather than race itself, are responsible for disparities in health outcomes. We highlight in this paper the use of race based glomerular filtration rate (GFR). It has been suggested that the current race based algorithm incorporating GFR is delaying diagnosis and treatment of worsening chronic kidney disease. Eliminating the race coefficient would improve the quality of life for individuals with CKD and prevent early progression to ESRD. The National Kidney Foundation and the American Society of Nephrology (NFK-ASN) task force recommends using CKD-epi using creatinine without the race coefficient to calculate GFR.