ARTICLE: Racial Adjustment Adversely Affects Glomerular Filtration Estimates in Black Americans Living with HIV
AUTHORS: Mohamed G Atta, Katie Zook, Todd T Brown, Dhananjay Vaidya, Xueting Tao, Paula Maier, George J Schwartz, Gregory M Lucas
JOURNAL: J Am Soc Nephrol. 2021 Sep;32(9):2143-2147. doi: 10.1681/ASN.2021030311. Epub 2021 Jun 17.
The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimating equations are commonly reported by clinical laboratories and used by clinicians to estimate GFR from intrinsic biomarkers (creatinine [eGFRcr], cystatin C, or both biomarkers [eGFRcr-cys]).1⇓–3 In the creatinine-based CKD-EPI equations, a race calibration factor is used to account for the observation that extrinsically measured GFR was higher, on average, in Black individuals compared with White individuals of the same sex, age, and serum creatinine concentration.4 However, in contrast with the experience in Black American (BA) individuals, the race coefficient has been found to degrade equation performance among native Black African people.5,6 In a recent study that included BA and White participants, we reported that eGFRcr was significantly more biased and less accurate than exogenously measured GFR in persons living with HIV than in those who were HIV negative.7
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