African Americans are at high risk for chronic kidney disease (CKD). *The data reported here have been supplied by the United States Renal Data System (USRDS). However, updated equations now exclude race and ethnicity when calculating eGFR. Adjusting eGFR based on race can have serious health and social implications. Your eGFR helps your healthcare team make the best treatment plan for you. An NKF and ASN task force has recently released a final recommendation for a way to determine eGFR thats not based on race. So, to find out your GFR, your creatinine test results are plugged into a math formula with other variables like your age and sex. African American people can use the following sources to find culturally competent healthcare professionals. By taking steps to manage your diabetes and live a health-promoting lifestyle, you can reduce your risk. Learn more about why this is here. If you have diabetes, your doctor will check your kidney function yearly by testing and measuring your GFR and urine albumin levels. Inker LA, et al. All Rights Reserved | Terms & Conditions | Privacy Policy | Social Media Participation Guidelines, Reference Intervals: The Process to Verify Outside Sources, Vitamin D: Its Physiology, Testing and Relationship with COVID-19, Our Experience with Touch Preparations of Lung Core Needle Biopsies. Researchers at multiple sites are currently conducting a phase I clinical trial on a gene therapy that could help patients get fewer injections in, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Your eGFR is an estimate of your kidney function thats also based on information like your age and sex. Controlling your blood pressure may help to protect your kidneys. (2014). (n.d.). Patients should be reassured that although eGFR is important and useful in interpreting creatinine, the diagnosis of chronic kidney disease does not hinge on any single calculated eGFR, and that the entire clinical context, including medical history, medication history, and adjunct laboratory markers of renal disease are crucial to the diagnosis. Levey A, Inker L, & Coresh J. This means that they often have higher eGFR scores than people from different ethnic backgrounds. The rationale for its use is based on differences in serum creatinine levels that experts still dont fully understand. These kidney filters are called glomeruli, and they remove waste from the blood. 2017;17(6):1540-1548. doi:10.1111/ajt.14113. The test gets its name from the . Research from 1999 also observed that serum creatinine levels in Black participants were higher than in white participants with the same calculated GFR value. It is important to mention that these factors are likely due, at least in part, to health inequities and structural racism in the medical community. Because early kidney disease often has no symptoms, a GFR test is a valuable tool for monitoring kidney function. How is CKD treated? People with CKD often take medicines to lower blood pressure, control blood sugar, and lower blood cholesterol. 2023UC Regents. A urine test checks for albumin in your urine, a sign of kidney damage. Choosing healthy foods, quitting smoking, and being more physically active are all important steps. It may be estimated from your blood level of creatinine. This led to the idea that factors influencing serum creatinine may differ between racial groups. "If your estimate, because you're African American, is GFR 23, but if you're white it's 19, that could definitely make a difference in terms of being listed or not listed," Peralta said. Once the result of the creatinine test is obtained, a lab technician or doctor will calculate your eGFR. Diabetic kidney disease can happen in both type 1 and type 2 diabetes. For this reason, they recommend using a new 2021 CKD-EPI creatinine equation to calculate eGFR, which excludes ethnicity as a factor. According to 2015 research, about half of people with type 2 diabetes develop diabetic kidney disease, compared with about one-third of people with type 1 diabetes. As part of the UCDH Working Group to address the question of using race in the calculation of eGFR, the Department of Pathology studied the feasibility of changing or eliminating the reporting of race from eGFR reporting. NKF and ASN form joint task force to focus on use of race in eGFR [Press release]. 2023 Healthline Media LLC. nonsteroidal anti-inflammatory drugs (NSAIDs), Association of Diabetes Care and Education Specialists, National Institute of Diabetes and Digestive and Kidney Diseases, Centers for Disease Control and Prevention, kidney.org/atoz/content/can-my-gfr-get-better, kidney.org/sites/default/files/11-10-0209_diabetes.pdf, niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease, ncbi.nlm.nih.gov/labs/pmc/articles/PMC7711563/, aacc.org/science-and-research/scientific-shorts/2021/is-a-black-race-coefficient-necessary-for-accurate-evaluation-of-egfr-using-creatinin, diabetes.org/diabetes/complications/kidney-disease-nephropathy, kidneyresearchuk.org/kidney-health-information/living-with-kidney-disease/how-can-i-help-myself/understanding-test-results/, journals.plos.org/plosone/article?id=10.1371/journal.pone.0081835, 10 Foods to Avoid with Kidney Disease and Diabetes, How to Screen for Diabetes-Related Nephropathy. Retrieved from https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/kidney-disease/laboratory-evaluation/glomerular-filtration-rate/estimating. Diabetes increases the risk of certain other health conditions, including kidney disease. GFR is a measure of how well your kidneys filter blood. A New Equation to Estimate Glomerular Filtration Rate. Ann Intern Med 2009;150(9): 604-612. These conditions include: In these cases, a doctor may opt to use other tests to assess your kidney function. This damage happens over many years. The coefficient for this equation is slightly lower than the one used for the MDRD equation. Makris K, Spanou L. Acute Kidney Injury: Diagnostic Approaches and Controversies. Your age, sex, and body weight can affect your muscle mass and the level of creatine in your blood. (2021). All rights reserved. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. People with severe kidney disease can develop cognitive symptoms like problems concentrating. (n.d.). The correction for African American patients can mean they get on a list months or years later than they otherwise might have. Last medically reviewed on February 17, 2022. In the acute phase, estimates of GFR are not particularly useful as GFR does not decline in a linear fashion with the rise seen in serum creatinine. Serum creatinine levels in the US population: third National Health and Nutrition Examination Study. When the MDRD equation was developed in 1999, it used race as a modifier to help better predict GFR in Black individuals. Race differences in prevalence of chronic kidney disease among young adults using creatinine-based glomerular filtration rate-estimating equations. Nephrology Dialysis Transplantation 2010;25(12): 3934-3939. This blog does not imply that UC Davis Health endorses the views expressed. Diabetes and chronic kidney disease: Stages 14. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction. A healthy kidney does not let albumin pass into the urine. The donated kidney can come from an anonymous donor who has recently died or from a living person. If your eGFR is less than 60 for three months or more, your kidneys may not be working well. Weis L, et al. Negative agreement was 91.2% for males and 93.4% for females, meaning that overall only a relatively small number of patients were reassigned to CKD positive status. What are the symptoms of CKD? (2021). For values below 60 mL/min/1.73 m 2, the report should give the numerical estimate rounded to a whole number (e.g., "32 mL/min/1.73 m 2 "). Researchers are currently working on alternative formulas that dont rely on creatinine. What happens during and after a clinical trial? Discover the link between type 2 diabetes and kidney disease, the leading cause of kidney failure in the United States. Our findings showed, as expected, a higher prevalence of CKD as defined by eGFR < 60 mL/min/1.73m2 utilizing the eGFR equation without a race parameter (NAA equation) compared to the equation with the parameter for race (AA equation). National Kidney Foundation. As noted in Omuse et al., the issue is not settled, and various studies have assessed the utility of the MDRD and CKD-EPI equations, with and without the race coefficient, for use in these populations with competing results.11 This in itself highlights the artificial nature of race as a social rather than biological construct and its limited utility as applied to estimating GFR. Subscribe to our blog and receive notifications of new stories by email. Kidney disease can be treated. In search of a better equation Performance and equity in estimates of kidney function. In the Asian population, normal GFR values could be somewhat lower than for Caucasians . This article explores what foods might, The kidneys are essential for balancing the body's internal environment. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. We are grateful to Dr. Lydia Howell and all of the UCDH Working Group participants for their advice and coordination in developing the action plan and helping to make these changes possible. (2013). (2021). The Modification of Diet in Renal Disease (MDRD) Study equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation are the most widely used equations for estimating GFR in adults. Estimating glomerular filtration rate. African Americans are at high risk for chronic kidney disease (CKD). This step is usually completed by a technician at the testing lab or by your doctor. Keep reading to learn more about this test, what the results mean, and how it plays a role in diabetic kidney disease. (2021). What does my eGFR mean? Important clinical trial terms to understand, Disaster preparedness for kidney patients, Mississippi tornadoes - Resources for kidney patients, Learn about the Living Donor Protection Report Card, View the Living Donor Protection Report Card, Addressing health disparities and advancing health equity, Addressing the impact of climate change on people with kidney disease, Improving early detection of kidney disease and addressing the unknown causes of kidney disease, Utilizing nutrition as a way to prevent and manage chronic diseases, Encouraging organ donation and supporting kidney transplants, Ensuring access to high quality, patient-centered care for Medicare beneficiaries with kidney disease, Ensuring adequate funding for kidney research and promoting innovation, Ensuring equity in the COVID-19 pandemic response, Fighting insurance discrimination against patients on dialysis, Protecting and enhancing access to health coverage under the Affordable Care Act, Medicaid, and employer-sponsored insurance, Protecting patient access to needed medications; supporting lower prescription drug costs, Improving Health Equity: Making Health Care Accessible to All, View the 2023 AKF Living Donor Protection Report Card, New AKF new microsite focuses on disparities in kidney disease, Decide when to refer you to a nephrologist or kidney doctor. This can help the eGFR score provide a more reliable indication of kidney functioning to guide diagnosis and treatment decisions. How do you check for CKD? We recommend you talk with your healthcare team to ask if your eGFR has changed and to learn how this may change your care. Before making any major changes to your lifestyle, be sure to talk with your doctor. As such, measures that are more clearly understood would serve as better indicators of kidney function. Instead, it uses a blood test to measure creatinine in order to estimate GFR. Two types of blood pressure medications - ACE inhibitors and ARBs - can slow CKD and delay kidney failure, even in people who do not have high blood pressure. 1. Chapter 2: Identification and Care of Patients with CKD. In 2018 USRDS annual data report: Epidemiology of kidney disease in the United States, vol. In most healthy people, the normal GFR is 90 mL/min/1.73 m2 or higher. Learn whether they are permanent and how it's sometimes, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. See additional information. You can learn more about how we ensure our content is accurate and current by reading our. Roberts DE. The formula to calculate eGFR uses the results of a serum creatinine test, but it also uses additional factors like your age, sex assigned at birth, and body size. If your eGFR is less than 90 for three months or more, your kidneys may not be working well. Alexander Ladenheim MD, Nam Tran PhD, Baback Roshanravan MD MS MSPH, Brian Young MD. A task force led by the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) was formed in 2020 to look into the use of race in the GFR test. All rights reserved. There are many places to find resources and support, such as: You can also find diabetes resources within the Healthline community. Reassessing the inclusion of race in diagnosing kidney diseases: An interim report from the NKF-ASN task force. the Modification of Diet in Renal Disease (MDRD) formula, developed in 1999, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, developed in 2009, race, specifically whether or not you are Black, a family history of kidney disease or associated conditions, implies that race is a biological construct, when its actually a social construct, automatically applies an across-the-board adjustment that doesnt account for the great amount of diversity thats found within the Black community, places people who identify as multiracial into a single racial category thats not reflective of their identity, inability to take some medications that are hard on the kidneys, such as some.
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