Use of Race in Estimating Glomerular Filtration Rate

Estimation of the glomerular filtration rate (GFR) generally is based on serum creatinine, age, and sex — and incorporates an adjustment for race (Black or non-Black). Recently, however, race-based adjustment has been questioned, and in two new studies, researchers have addressed this issue.

In one study, researchers compared directly measured GFR (using urinary ¹²⁵I-iothalomate clearance) and estimated GFR (eGFR) in 1248 adults with chronic kidney disease of varying severity; 37% of participants self-identified as Black and 63% as non-Black. When race was omitted from the calculation of creatinine-based eGFR, the eGFR was less accurate than when race was included; the same pattern was found when genetic ancestry was substituted for race. Ho…