Clinicians estimate kidney function to guide important medical decisions across a wide range of settings, including assessing the safety of radiology studies, choosing chemotherapy, and reviewing the use of common nonprescription medications such as nonsteroidal anti-inflammatory drugs. Because direct measurement of kidney function is infeasible at the bedside, the usual approach involves using estimating equations that rely on serum creatinine. These equations assign a higher estimated glomerular filtration rate (eGFR) to patients who are identified as black. Yet in some medical and social science disciplines, a consensus has emerged that race is a social construct rather than a biological one.1 In this Viewpoint, we argue that the use of kidney function estimating equations that include race as a variable cause problems for transparency and unduly restrict access to care in some cases, yet offer only modest benefits to precision.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Eneanya ND, Yang W, Reese PP. Reconsidering the Consequences of Using Race to Estimate Kidney Function. JAMA. Published online June 06, 2019322(2):113–114. doi:10.1001/jama.2019.5774
Browse and subscribe to JAMA Network podcasts!
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: