Racial discrimination has been a lightning rod for passionate discourse and social action in the US for decades, if not centuries. The recent killings of African Americans by law enforcement has amplified the discourse. Health care has not been immune to such tragedies, with past experimentation without informed consent and segregation in health care facilities. These were systemically ingrained, institutional practices without ethical or evidentiary footing. Race was an identifying characteristic used to implement practices that resulted in consequences for health and well-being. The use of race in algorithms for clinical care, including for kidney disease, has generated and now even more so is generating discourse and action about current-day, systemic discrimination in health care.