Removing race from kidney function algorithm helped more Black patients access transplants

Anil Oza, Stat

Researchers said the new study shows these kinds of modifications can help limit disparities

Several years ago, nephrologists attempted a first-of-its-kind effort: remove race from a key clinical algorithm, and attempt to undo the harms of the race-based equation for those who were still being negatively affected by it. 

Until 2021, eGFR, which is used to measure kidney function, was inflated by around 16% to 21% for Black patients — which could mask severe kidney disease and delay urgently needed transplants. Not only was the equation phased out in 2022, but the Organ Procurement and Transplantation Network mandated that transplant programs submit modifications for Black patients waiting for transplants. 

A new study found the change had big results, impacting 27% of Black patients and resulting in 5.3 more transplants per 1000 Black candidates.

“These tangible results are not only significant for nationwide efforts to ensure that kidney transplantation in the United States is fair and equitable for all those facing kidney failure, but they are deeply meaningful for the more than 21,000 people who have received wait time modifications since this policy was implemented,” LaVarne A. Burton, president and CEO of the American Kidney Fund, said in a statement in response to the paper, published in JAMA Internal Medicine Monday. 

Health services researcher and Boston Medical Center resident physician Rohan Khazanchi, who was one of the paper’s authors, said the group was interested in examining “this type of reparative intervention that’s thinking about the people who were harmed by the fact that this race-based algorithm was in place, and trying to come up with a remedy that actually addresses some of that harm” because it’s “the first time that’s been done on a national scale.” 

Learn about the long process of removing race from the eGFR.

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