Recording: NSA Role of Race in Clinical Algorithms 2.25.2022_2.25.2023
Full Title: Recording: NSA Reconsidering the Role of Race in Clinical Algorithms: Removal of Race Based Estimated GFR Reporting 2.25.2022_2.25.2023
All current eGFR calculations are scientifically limited and are not fully precise or accurate. For almost two decades, equations to determine kidney function have used race “Black” and “Not Black” as an attempt to accurately estimate kidney function among adult patients. This race-based approach has unfortunately perpetuated biases in medicine regarding race as a biological construct, race as a highly discriminating factor of kidney function, and the binary description of race as an inclusive representation of our society. Biases in medicine including race based eGFR combined with health care disparities play a significant role on the disproportionate burden of chronic kidney disease and the inequity of therapies including transplant and home dialysis among minority populations, particularly Black patients.
Physicians use clinical medical algorithms to individualize risk assessment and guide clinical decisions. By embedding race into the basic data and decisions of health care, these algorithms propagate race-based medicine. Many of these race-adjusted algorithms guide decisions in ways that may direct more attention or resources to white patients than to members of racial and ethnic minorities. Race based clinical medicine algorithms propagate multiple biases that we in clinical medicine are responsible for.
Institution wide change that aligns clinical science and equity in medicine: 1) Clinically appropriate explanation of eGFR as an estimate; 2) Enhance equity among our diverse population; 3) Inclusive to all members independent of ethnicity, race, gender, body composition, and chronic illnesses.
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All clinicians who treat patients with chronic kidney disease and all other interested clinicians.
¨ Provide Lab reporting inclusive to the diverse population we serve
¨ Reduce implicit bias about the role of race in estimating kidney function, the categorization of race, and the assumption of race in clinical medicine
¨ Reduce systemic racism in medicine -specifically CKD , and the assumption of race in clinical medicine
¨ Reduce systemic racism in medicine -specifically CKD screening, diagnosis, management, and eligibility for renal transplant at KP NCAL
¨ Expand equitable care for all patients independent of race (ancestry), ethnicity, gender, body composition, and chronic illness
Keedra McNeill, MD, and Tatjana Kolevska, MD
Sharina Belani, MD, Nephrology Chief, Kaiser Permanente, San Rafael, Chair of Chiefs, Nephrology
Kaiser Permanente Napa/Solano has determined that today's speaker and planner(s) do not have affiliations with any corporate organizations that may constitute a conflict of interest with this presentation. Kaiser Permanente Napa/Solano takes responsibility for the content, quality and scientific integrity of this CME activity. Kaiser Permanente does not endorse any brand-name products.
Kaiser Napa/Solano is accredited by the California Medical Association (CMA) to provide continuing medical education for physicians. The Kaiser Napa/Solano designates this Live Activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 0.75 AMA PRA Category 1 Credit(s)™