Why do the eGFR results for black people need to be multiplied by 1.2 on the uk
eGFR results for black people: Why do the... - Kidney Disease
eGFR results for black people
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Hi and welcome to the community. I've posted an article that can better explain this for you. Hope this answers your question.kidney.org/atoz/content/rac...
Thank you for replying to my question of why the eGFR results of black people need to be multiplied by 1.2. Sadly the websites you suggested did not seem to answer the question, unless I missed it. They mainly stated that black people and other BAME people suffered from CKD disproportionately compared to whites. Black people being 4 times more likely in fact than whites. My question is why do their results have to be multiplied by 1.2. Should it not be the reverse.? Should not the threshold be lower? My GP doesn't know which is why I'm turning to a Kidney organisation
While the entire article should be taken in total as a reason, I've copied and pasted below the specific reason mentioned.
How is race used in estimating GFR?
The eGFR is calculated from the amount of creatinine in the blood using a math equation. Creatinine is a waste product that comes from the normal wear and tear on muscles of the body and also from the diet. Everyone has creatinine in their bloodstream. However, different people can have different creatinine levels in their blood. This difference is not always related to kidney disease, and it can be affected by different factors, such as age, sex, body weight and/or race. Several equations have been created to measure eGFR using a combination of these factors with the goal of getting a more accurate measure of kidney function.
Studies have shown that individuals who self-identify as Black or African Americans can have higher levels of creatinine in the blood (on average), compared to people of other races or ethnicities. However, otherwise similar Black and White Americans can have the same blood creatinine level, but also have different eGFRs for reasons that can include differences in muscle mass, differences in diet and differences in the way the kidneys eliminate creatinine.
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Ok thank you for your time Mr Kidney. So if one of the factors for blacks suffering disproportionately with CKD is to do with having greater muscles mass than whites does that mean they should avoid exercise that increases muscle mass.
As a lay person that would make sense to me however, a more detailed and educated answer would be best coming from a knowledgeable physician.
It is a racist practice that delays treatment for black people. It is based on one, very old study with a very small sample size and has continued for years without scientific rationale. Several doctors and medical students are questioning the practice in the US and some are successfully eliminating the two eGFR scores. It is part of the systemic racism in the US and delays treatment for blacks in favor of earlier treatment for whites and increase the fatality rate among black people with CKD. You can google the topic and find many articles explaining this. You will find just as many racists saying there is a difference in the muscle mass of black people. This is the same kind of racist "facts" used to support why black people were made for slavery.
Here are just a few articles, from highly reputable publications, on the racism in eGFR.
ajmc.com/view/flawed-racial...
statnews.com/2020/07/17/egf...
medicine.uw.edu/news/uw-med...