Black patients are about four times as likely to have kidney failure as white Americans, and make up more than 35% of people on dialysis but just 13% of the U.S. population. They’re also less likely to get on the waitlist for a kidney transplant, and less likely to receive a transplant once on the list.
An algorithm doctors use may help perpetuate such disparities. It uses race as a factor in evaluating all stages of kidney disease care: diagnosis, dialysis and transplantation.
It’s a simple metric that uses a blood test, plus the patient’s age and sex and whether they’re Black. It makes Black patients appear to have healthier kidneys than non-Black patients, even when their blood measurements are identical.
This race coefficient has recently come under fire for being imprecise, leading to potentially worse outcomes for Black patients and less chance of receiving a new kidney. A national task force of kidney experts and patients is studying how to replace it. Some institutions have already stopped using it.
But how best to assess a patient’s kidney function remains uncertain, and some medical experts say fixing this equation is only one step in creating more equitable care.
