Reassess Inclusion of Race in Estimated Glomerular Filtration Rate (eGFR) Equation

At a glance

Current policy

The estimated glomerular filtration rate (eGFR) calculation is a tool used by kidney transplant programs to measure a patient’s kidney function. The calculation is also one of the ways that a transplant candidate can qualify for kidney waiting time. Waiting time is an important factor for the order in which kidneys are offered to candidates. Race is a variable that is used in some eGFR calculations, and it can cause kidney function to seem better than it really is for Black kidney candidates. Right now, OPTN policy doesn’t say if this variable should or should not be used. In March 2021, the OPTN formed the Reassess Race in eGFR Workgroup (the Workgroup) to evaluate the impact the Black race in eGFR calculations has on the wait time criteria for kidney transplants.

Supporting media

Presentation

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Requested feedback

The OPTN Minority Affairs and Kidney Transplantation Committees are seeking feedback on the following items to inform a future proposal:

• For transplant programs:
  • Which method of estimating or measuring GFR is your transplant program currently using? Why?
  • How would using a race-neutral eGFR affect your program?
  • What implementation challenges could use of a race-neutral eGFR present for your transplant program?
  • What resources could assist in facilitating a smooth transition for your program?
  • What potential consequences should be considered during this proposal's development?
• For patients:
  • Do you support the use of a race-neutral eGFR formula? Why or why not?

Anticipated impact

• What it's expected to do
  • Gather community feedback to inform a future proposal that aims to make access to kidney transplants more equitable for Black kidney candidates
• What it won't do
  • This Request for Feedback will not result in a policy change
    
    

Themes

• eGFR calculation
• Equity in transplantation
• Wait Time calculation

Terms to know

• Estimated glomerular filtration rate (eGFR): A tool used to measure how well a patient’s kidneys are functioning.
• Black Race coefficient: A factor that is used in some eGFR calculations. It was developed based on a study that recent research shows may not be reliable or valid.

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