The journey of Curtis Warfield, a Black man diagnosed with kidney disease, started in 2005 when protein was found in his urine during a routine checkup. It wasn’t until 2012 that he was diagnosed with stage 3 kidney disease, eventually leading to dialysis in 2014.
Struggling with the implications of his illness, Warfield faced a form of covert racism in the medical system due to a mathematical equation called the estimated glomerular filtration rate or eGFR, which factored in his race when assessing his kidney function.
Critics have long questioned the inclusion of race in the eGFR equation, highlighting the disparities it creates for Black individuals with kidney disease. As awareness grew, multi-organization efforts led to the development of two new, race-neutral equations for estimating kidney function in an effort to combat institutional racism in kidney care.
One of the major issues with the race-based eGFR is its impact on treatment recommendations, with Black individuals often receiving different care based on their higher eGFR scores compared to other races. The push to eliminate race from kidney estimations is seen as a crucial step in reducing disparities in kidney disease and treatment, especially given the disproportionate risk Black Americans face in developing kidney-related conditions.
The effort to do away with race as a factor in kidney estimations gained momentum as academic institutions, including University of Washington Medicine, took steps to remove the race variable from their medical equations. This shift reflects a broader movement within the medical community to address systemic racism and move toward race-neutral approaches in healthcare.
Advocates, researchers, and organizations continue to work towards a more equitable and race-neutral approach in kidney care, acknowledging the harmful effects of race-based algorithms on individual healthcare decisions and the broader impact on systemic racism within the medical field.
In 2021, the task force formed by leading kidney organizations released new equations for kidney function estimation, both devoid of any racial factors. While these equations may be slightly less precise than the previous race-based eGFR, they represent a significant step towards eliminating racial disparities in kidney care.
The implementation of the new equations is already underway, with major labs expected to make the transition in the coming months. Despite the challenges in precision, the new equations are viewed as estimates that should be part of a broader clinical assessment rather than the sole determinant of care decisions.
The changes in kidney function estimation reflect a broader understanding of race and its social, rather than biological, construct. Moving away from race-based algorithms in healthcare decision-making is viewed as a positive step towards addressing systemic racism and promoting equitable healthcare for all individuals.
As the medical community continues to engage in discussions about race in healthcare, the focus on eliminating race from kidney estimations signals a shift towards more inclusive and equitable practices in the field. While the journey towards eliminating racial disparities in healthcare is ongoing and complex, the move towards race-neutral equations in kidney care is seen as a crucial step in the right direction.
The historical roots of race-based equations in kidney care highlight the need for ongoing dialogue and action to address systemic racism in medicine. By challenging preconceived notions about race and health, healthcare professionals and advocates are working towards a more fair and just healthcare system for all individuals, regardless of race or ethnicity.
Eliminating race from kidney estimations represents a significant milestone in the fight against racial disparities in healthcare. While it may not single-handedly solve deep-rooted issues, such as historic racism and unequal access to healthcare, the shift towards race-neutral approaches in kidney care is a positive step towards creating a more equitable and inclusive healthcare system for everyone.
Individuals like Curtis Warfield, who have experienced the impact of race-based algorithms firsthand, are advocating for change and actively participating in discussions to address systemic racism in the medical field. By amplifying patient voices and promoting awareness of healthcare disparities, progress towards a fair and just healthcare system is being made.
The journey towards race-neutral healthcare practices is a complex and ongoing process that requires collective action and sustained efforts. While eliminating race from kidney estimations is a crucial step, it is just one piece of the puzzle in addressing broader healthcare disparities rooted in racism and systemic inequality.
By challenging existing algorithms and advocating for race-neutral approaches in healthcare decision-making, individuals like Curtis Warfield are paving the way for a more just and equitable healthcare system. The impact of these changes extends beyond the equations themselves, sparking conversations and actions to address the systemic issues of racism and inequality in healthcare.