Abstract: PO0518
Impact of the Race Multiplier in the Estimated Glomerular Filtration Rate Equation on Care Delivery Among African-American CKD Patients
Session Information
- CKD Health Services Research
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Ahmed, Salman, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Mendu, Mallika L., Brigham and Women's Hospital, Boston, Massachusetts, United States
Background
African-American patients with chronic kidney disease (CKD) have poorer outcomes, including in dialysis access placement and transplantation. Estimated glomerular filtration rate (eGFR) equations, which assign higher eGFR values to African-American patients, may be an inadvertent mechanism for inequitable outcomes. Electronic health record-based registries enable population-based examination of care across racial groups.
Methods
Cross-sectional study at two large academic medical centers and affiliated community primary care and specialty practices.
Results
Of 2225 African-American patients, 743 (33.4%) would hypothetically be reclassified to a more severe CKD stage if the race multiplier were removed from the CKD-EPI equation. Similarly, 167 of 687 (24.3%) would be reclassified from stage 3B to stage 4. Finally, 64 of 2069 patients (3.1%) would be reassigned from eGFR > 20 ml/min/1.73m2 to eGFR < 20 ml/min/1.73m2, meeting the criterion for accumulating kidney transplant priority. Zero of 64 African-American patients with an eGFR <20 ml/min/1.73m2 after the race multiplier was removed were referred, evaluated or waitlisted for kidney transplant, compared to 19.2% of African-American patients with eGFR<20 ml/min/1.73m2 with default CKD-EPI equation.
Conclusion
Our study reveals a meaningful impact of race-adjusted eGFR on the care provided to the African-American CKD patient population.
Funding
- Private Foundation Support