Ever since medicine adopted a race-based formula to assess kidney health in the mid-2000s, some experts have spoken out against it. The fight to remove a “Black or not Black” dichotomy from the kidney test equation, known as the estimated glomerular filtration rate (eGFR), has picked up steam in recent years, culminating in a recommendation from the National Kidney Foundation and the American Society of Nephrology to remove the race variable.
But for countless people living with kidney disease, the recommendation comes too late. People like Glenda Roberts, who long self-identified as Black, and who has lived with kidney disease for most of her adult life. The “Black correction” in the eGFR made it look like her kidneys were doing better than they actually were, which delayed her being worked up for a kidney transplant. This delay led Roberts into an unplanned “crash into dialysis” before her transplant workup was complete.
A few years after the transplant, a genetic test Roberts had done by Ancestry.com indicated that she had only 48% African ancestry. Had she known that earlier, identifying as not Black would have helped her get on the kidney transplant list sooner.
On this week’s “First Opinion Podcast,” Roberts and kidney specialist Vanessa Grubbs, a longtime critic of using race in the eGFR, spoke about the impact this equation has had on patients’ lives and whether the profession has truly reckoned with it.
“Nephrology is a is a field of equations — there’s an equation to calculate everything to two and three decimal places. But when it comes to race, if you think you’re Black, that’s Black enough,” Grubbs said.
The conversation stems from Roberts’ First Opinion essay, “Had I done Ancestry.com sooner, I could have gotten a kidney transplant two years earlier.”
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