(HealthDay News) — Black patients have a shorter time from estimated glomerular filtration rate (eGFR) levels of ≤20 mL/min/1.73 m2 to end-stage kidney disease (ESKD) onset than Whites, according to a study published online in the Journal of the American Society of Nephrology.
Elaine Ku, MD, from the University of California San Francisco, and colleagues compared racial differences in accruable wait time and kidney transplant preparation in participants of the Chronic Renal Insufficiency Cohort (CRIC), based on estimates of kidney function by creatinine (eGFRcr), cystatin C (eGRFcys), or both (eGFRcr-cys).
The researchers found that 444 CRIC participants were eligible for wait-list registration by eGFRcr, but Blacks had 32% shorter time than Whites in the potential time between eGFR of ≤20 mL/min/1.73 m2 and ESKD. Four hundred thirty-five participants were eligible by eGFRcys, with Blacks having 35% shorter potential wait time than Whites. Four hundred sixty-one participants were eligible by eGFRcr-cys, with Blacks having a 31% shorter potential wait time than Whites. Racial equity in accruable wait time prior to ESKD onset could be improved by registering Blacks on the wait list as early as an eGFR of 24 to 25 mL/min/1.73 m2.
“We found that use of a higher kidney function threshold to allow for earlier eligibility for waitlisting in Blacks could theoretically reduce the racial disparity in time spent in the advanced stages of chronic kidney disease,” Ku said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.
Ku E, McCulloch CE, Adey DB, Li L, Johansen KL. Racial disparities in eligibility for preemptive waitlisting for kidney transplantation and modification of eGFR thresholds to equalize waitlist time. J Am Soc Nephrol.
March 32(3);677-685. doi:10.1681/ASN.2020081144
Levey AS, Inker LA, Goyal N. Promoting equity in eligibility for registration on the kidney transplantation waiting list: looking beyond eGFRcr. J Am Soc Nephrol. 32(3);523-525. doi:10.1681/ASN.2020121802