Application of race-based GFR among emergency physicians



Although race is a social, rather than biologic, construct, several commonly used medical calculations and algorithms continue to use race as a variable.

The calculation for GFR includes race as a variable with a correction factor that increases GFR for those with “Black” race. 

Unfortunately, there continue to be racial disparities among patients with renal failure, with African-American patients more likely to have worse outcomes.

It is possible that the use of race-based calculations to estimate GFR inappropriately make renal function appear better than it is in African-American patients, leading to delays in care (e.g. referral to nephrology, initiation of dialysis, renal transplantation).  If so, this is a form of structural medical racism.

There is currently a task force through National Kidney Foundation that has been established to reassess inclusion of race in diagnosing kidney disease.