Excited to join trainees from across the country at tonight’s @NKF @ASNKidney Task Force Forum. I’ll be providing live testimony along with @glass_heff_full @JamesADiao @luiz_sayha @jes_cerdena & more.

Want to listen or submit written testimony? https://www.kidney.org/content/nkf-asn-task-force-reassessing-inclusion-race-diagnosing-kidney-diseases

. @jes_cerdena up first, speaking as a mother & scholar: "Race is a sociopolitical construct, not a biological fact.... that is to say, the color of my son’s skin has nothing to do with his kidneys’ ability to filter and excrete waste products." #NKFASNforum

. @jes_cerdena: "As a Spanish-speaking Latino boy, my son may be subject to racial discrimination that could affect his kidney health, and no equation currently accounts for that. We need to redirect our attention away from race-as-biology and instead toward antiracism-as-policy."

. @JamesADiao, recent @JAMA & @NEJM author: "As leading scholar and advocate Dr. @DorothyERoberts wrote: harm results from treating Whiteness as the human standard and from treating Black people as biologically distinct; we need to end both." #NKFASNforum

. @JamesADiao: "The monolithic label of “Black” does not reflect the enormous diversity it contains, especially given the ever-changing spatial, temporal, and political delineations of race."

. @JamesADiao: "This topic is often framed as a choice between ethics and evidence, or between race-based medicine and colorblindness. This simply isn’t true... surely we can figure out something better than race"

. @glass_heff_full: "What race is my friend whose grandparents were of Irish, Korean, Ghanaian, and Salvadoran descent? Should a physician decide which patient has “enough” racial background to count? In multi-racial people, should a “one-drop” rule apply?" #NKFASNforum

. @glass_heff_full: "How should these correction factors be applied to Black immigrants from Brazil and South Africa, countries in which studies have shown no racial differences in eGFR? What about a white patient who received a transplanted kidney from a Black patient?"

. @glass_heff_full: "Racial differences in health outcomes in the US are due to #RACISM, not race. We as physicians and scientists do our patients an incredible disfavor when we neglect to determine and address racism as the true root cause of racial inequity."

My testimony up next: "As a physician-in-training, I am anxious about this inequitable status quo. I cannot imagine sitting down with a black patient and telling them they will not receive optimal treatment because of their race."

My testimony: "Removal of race would make 14,000 Black patients newly eligible for kidney transplants, 45,000 for Medicare coverage of CKD education, 60,000 for specialist referral, and 130,000 for medical nutrition coverage."

"These are some of the most crucial interventions with evidence-based potential to slow the progression of disease -- yet, our current eGFR equation denies access to these resources for hundreds of thousands of Black patients."

"Though cystatin C is indeed more expensive than Cr, it is still cheaper than a troponin! This task force’s recommendations can also drive advocacy groups and policymakers to advocate for further expansions of cystatin C access & uptake in the name of health equity."

My closing comment: "Dismantling racism in medicine must include dismantling clinical practices which incorrectly conflate race with biological traits." #RacismNotRace #EndRaceBasedMedicine #NKFASNforum

. @sundazedelia on behalf of @SNMA: "Race correction, and its ties to racism, has no place in modern medicine... achieving a more just and precise approach to medicine is worth the growing pains."

. @luiz_sayha with the #MedPeds FACTS on peds -> adult transitions of care & eGFR: "When studied, the Schwartz and CKD-EPI equations exhibit poor agreement in patients before and during the transition period with CKD-EPI consistently yielding higher eGFRs."

. @luiz_sayha: "Achieving equity is hard, but this Task Force has a unique opportunity to make this a little bit easier and unequivocally state that Black Lives Matter."

Testimony just finished. ALL THIRTEEN TRAINEES testified in support of removing race from eGFR. The future of medicine has spoken -- we are looking to our medical community for the leadership & courage to change.

@NKF @ASNKidney

#RacismNotRace #EndRaceBasedMedicine #NKFASNforum