Race-Based Kidney Equation in African-Americans Needs Reevaluating

Researchers are giving the race-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation another look. The equation is used for estimating glomerular filtration rate (eGFR). Kidneys filter the blood of wastes and toxins, allowing them to be expelled through urine. If the kidneys operate at reduced function or fail completely, the patient has Chronic Kidney Disease
(CKD). There is no cure for CKD, except for transplant. It affects 10% to 13% of the adult population.

Those with the condition are at a higher risk of cardiovascular complications and premature death. Researchers say new data from removing the coefficient for Black race from the CKD-EPI equation will reclassify substantial numbers of Black individuals in the United States.

The new classification will list them as having stage 3 or higher. The researchers looked at 2 contemporary national cohorts of Black adults. There were a total of 9682 patients, all self-identifying as Black who participated in National Health and Nutrition Examination Surveys (NHANES) surveys from 1999 until 2018. 786,718 patients were Black veterans in the Veterans Affairs Health System from 2018.

After the change, the general US Black population (mean age 44 years, 44% male), mean eGFR decreased from 102.8 mL/min/1.73 m2 using the CKD-EPI equation with the Black race coefficient to 88.1 mL/min/1.73 m2. Among the Black veterans, mean age 58.1 years; 84% male, the change meant a mean eGFR decreased from 82.9 to 71.6 mL/min/1.73 m2.

After elimination of the coefficient in the general population of Blacks, researchers found an increased prevalence of individuals with CKD, the rate going from 5.8% to 10.4%. Researchers said, using this new equation, an additional 981,038 Black individuals with purportedly higher kidney function would be reclassified as having stage 3 CKD. In addition, 67,957 Black adults with stage 3 disease would be reclassified as having stage 4 or 5 CKD.

Among Black veterans, CKD prevalence increased from 15.5% to 26.3%. 84,988 additional Blacks were diagnosed with stage 3 disease and 6253 being reclassified from stage 3 to stage 4 or 5 CKD. For more of the latest on kidney related news, be sure to follow Healthy Kidney Inc. on YouTube