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I teamed up with @kcnorris_ucla and @EbonyBoulware to write this @JAMA_current editorial on a study that focuses on the removal of #race in #eGFR equations. We reaffirm that in medicine, we must first do no #harm. A thread
https://jamanetwork.com/journals/jama/fullarticle/2773807
https://jamanetwork.com/journals/jama/fullarticle/2773807
Diao et al. analyzed NHANES data to show that removing race from eGFR equations would increase the crude prevalence of CKD among Black Americans (14.9% to 18.4% or approximately 1 million individuals). Eligibility for Medicare to cover medical nutrition and CKD education also
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The authors also reported that removing race could lead to a potential loss of crucial medications (e.g., SGLT2 inhibitors, metformin) and less eligibility for living kidney donation (approximately 16,000 Black individuals).
So are we helping or harming patients when we remove race from equations? Let's review that math
. This approach could lead to 1 MILLION Black Americans receiving timely preventative CKD care including aggressive management of blood pressure and diabetes.
. This approach could lead to 1 MILLION Black Americans receiving timely preventative CKD care including aggressive management of blood pressure and diabetes.
We also know that there is an increased risk of death with late referrals to #nephrology. Let's contrast this with the potential and unfortunate loss of lifesaving medications and donor eligibility for several THOUSAND Black Americans. We acknowledge there is a trade-off.
However we strongly believe that ensuring timely and equitable #nephrology care for Black Americans while minimizing harms of inappropriate care underlies the central medical principle of "Do no harm". Harm includes using Black race to dictate care and widen existing disparities.
Will we use the growing scientific evidence base to finally do the right thing and stop race correction in nephrology?? Read the original study by Diao et al. here 
https://jamanetwork.com/journals/jama/fullarticle/2773808
https://jamanetwork.com/journals/jama/fullarticle/2773808
In case you missed it, check out our other research study published in @JournalGIM which describes the harms of using Black race in #eGFR equations. https://link.springer.com/article/10.1007/s11606-020-06280-5
Let's continue to disseminate widely. #inequitykills. @DorothyERoberts @michellemorse @CamaraJones @DrAlethaMaybank @PeterPReese1 @tsaiduck77 @SKostelanetz @NNkinsi @rohankhaz @dereckwpaul @DrRayMD @UREssien @uche_blackstock @RheaBoydMD @LashNolen @DrDeidraCrews @EbonyJHilton_MD
