Taking An ‘Affirmative Action’ Approach To Kidney Disease Diagnosis

Black patients appear to be less ill than they really are, according to some experts who use the most common method of assessing the condition. There is a new report calling for the formula to be scrapped.

A scientific task force recommended on Thursday that the kidney function test be jettisoned. It adjusts the results based on racial differences, making it difficult to determine the condition of patients of color.

Taking An ‘Affirmative Action’ Approach To Kidney Disease Diagnosis

Black patients may appear to be less ill as a result of the adjustment, according to many experts. A report by the National Kidney Foundation and the American Society of Nephrology stressed the importance of a race-neutral approach when it comes to diagnosing and managing kidney disease.

The NAS-published study describes the equation for the specific problem. Those affected by the change are likely to receive hundreds of millions of kidney function tests each year, both as part of a variety of outpatient procedures and as part of routine blood testing for blood disorders and kidney disease.

A study predicted that one million Black Americans would have had access to treatment earlier if the kidney disease diagnostic equation had been adjusted for race.

Currently, a national conversation is underway on racial health disparities, with the report of the task force appearing in the American Journal of Kidney Diseases and the Journal of the American Society of Nephrology simultaneously. As a result of the Covid-19 pandemic, people of color have been disproportionately affected and chronic disease burdens have been highlighted in those communities.

This issue is a moral matter, said Dr. Neil R. Powe, chief of medicine at Zuckerberg San Francisco General Hospital and Trauma Center. Getting rid of race is the solution to this, he said.

A high rate of conditions such as diabetes, hypertension, and obesity have been prevalent in Black and Hispanic Americans, which can exacerbate the condition.

Developing kidney disease is also at risk due to these factors. Kidney disease has a stark and well-documented racial disparity. There is a three to one ratio between black and white Americans for kidney failure requiring dialysis or transplant.

Only 13 percent of Americans qualify for kidney failure, but 35 percent of them are black. Nearly one-third as many Black Americans as Whites are on a kidney waiting list. In low-income groups and racial minorities, chronic kidney disease is less likely to be diagnosed at its earliest stage.

The Centers for Medicare and Medicaid Services found that people with chronic kidney disease are more likely to progress to kidney failure and require dialysis.

Among Black Americans, organ transplantation extends longer, and friends and family are less likely to donate kidneys. Taking steps to prevent racial biases in clinical care will help patients no longer be judged by their skin color and will encourage the better treatment of kidney disease, according to the task force member, Dr. Nwamaka Denise Eneanya.

According to her research, current measures used to assess kidney function might underestimate black patients’ illnesses, implying a delay in referrals to specialists and a reduced likelihood of them being placed on kidney transplant waiting lists.

Another task force member cautioned that the impact of the changes on patient outcomes was uncertain and recommended that researchers follow up to investigate its effect. It is not unique to kidney disease when physicians make medical decisions based on race and ethnicity.

Researchers outlined in a paper published last year in the New England Journal of Medicine that doctors use algorithms and calculators to determine diagnoses and treatments for many conditions – from bone density to kidney stones and lung function – that include race as a factor.