Reassessing the Inclusion of Race in Diagnosing Kidney Diseases: An Interim Report from the NKF-ASN Task Force.

Autor:	Delgado C; Nephrology Section, San Francisco Veterans Affairs Medical Center, Division of Nephrology, University of California San Francisco, San Francisco, California., Baweja M; Nephrology Division, Department of Medicine, Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai, New York, New York., Burrows NR; Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia., Crews DC; Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Eneanya ND; Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Gadegbeku CA; Department of Medicine, Section of Nephrology, Hypertension and Kidney Transplantation, Temple University, Philadelphia, Pennsylvania., Inker LA; Division of Nephrology, Tufts Medical Center, Boston, Massachusetts., Mendu ML; Division of Renal Medicine and Office of the Chief Medical Officer, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Miller WG; Department of Pathology, Virginia Commonwealth University, Richmond, Virginia., Moxey-Mims MM; Division of Nephrology, Children's National Hospital, Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC., Roberts GV; External Relations and Patient Engagement, Kidney Research Institute, Center for Dialysis Innovation, University of Washington, Seattle, Washington., St Peter WL; College of Pharmacy, University of Minnesota, Minneapolis, Minnesota., Warfield C; National Kidney Foundation, New York, New York., Powe NR; Department of Medicine, Priscilla Chan and Mark Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, California.
Jazyk:	angličtina
Zdroj:	Journal of the American Society of Nephrology : JASN [J Am Soc Nephrol] 2021 Jun 01; Vol. 32 (6), pp. 1305-1317. Date of Electronic Publication: 2021 Apr 09.
DOI:	10.1681/ASN.2021010039
Abstrakt:	For almost two decades, equations that use serum creatinine, age, sex, and race to eGFR have included "race" as Black or non-Black. Given considerable evidence of disparities in health and healthcare delivery in African American communities, some regard keeping a race term in GFR equations as a practice that differentially influences access to care and kidney transplantation. Others assert that race captures important non GFR determinants of serum creatinine and its removal from the calculation may perpetuate other disparities. The National Kidney Foundation (NKF) and American Society of Nephrology (ASN) established a task force in 2020 to reassess the inclusion of race in the estimation of GFR in the United States and its implications for diagnosis and subsequent management of patients with, or at risk for, kidney diseases. This interim report details the process, initial assessment of evidence, and values defined regarding the use of race to estimate GFR. We organized activities in phases: ( 1 ) clarify the problem and examine evidence, ( 2 ) evaluate different approaches to address use of race in GFR estimation, and ( 3 ) make recommendations. In phase one, we constructed statements about the evidence and defined values regarding equity and disparities; race and racism; GFR measurement, estimation, and equation performance; laboratory standardization; and patient perspectives. We also identified several approaches to estimate GFR and a set of attributes to evaluate these approaches. Building on evidence and values, the attributes of alternative approaches to estimate GFR will be evaluated in the next phases and recommendations will be made. (Copyright © 2021 by the American Society of Nephrology and the National Kidney Foundation, Inc. All rights reserved.)
Databáze:	MEDLINE
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