HealthDay News — In a final report from the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) Task Force, published online Sept. 23 in both the American Journal of Kidney Diseases and the Journal of the American Society of Nephrology, recommendations are presented for a race-free approach to estimated glomerular filtration rate (eGFR) equations.
Cynthia Delgado, M.D., from the University of California in San Francisco, and colleagues clarified the problem relating to eGFR equations, evaluated approaches to address use of race in estimation of GFR, and developed recommendations. Five approaches for estimation of GFR were evaluated, while considering six attributes of each approach.
The authors recommend immediate implementation of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation refit without the race variable in all U.S. laboratories for adults; this does not include race in the calculation and reporting, does include diversity in its development, is immediately available, and has acceptable performance characteristics and potential consequences that do not impact any one group disproportionately. National efforts to facilitate increased, routine, and timely use of cystatin C are recommended, especially to confirm eGFR in adults who are at risk for, or who already have, CKD. The CKD-EPI eGFR-cystatin C and eGFR creatinine-cystatin C refit without the race variables should be adopted if ongoing evidence supports acceptable performance. Research on GFR estimation with new filtration markers and on interventions to eliminate race and ethnic disparities is encouraged and should be funded.
“This recommendation by the NKF-ASN Task Force is an important step forward in assuring health and health care equity,” Paul M. Palevsky, M.D., president of the NKF, said in a statement.