The Race Modifier is no longer recommended for use in determining the GFR
There is an important GFR Bulletin that is enlightening but more important for people of African Descent or who identify as Black as it helps ensure early referral and therefore better outcomes.
Understanding Your Kidney Blood Test: 3 Important Things to Know
The American Society of Nephrology (ASN) and The National Kidney Foundation (NKF) no longer recommend including the race modifier for calculation of the GFR because the race modifier was causing a few issues. The race modifier was resulting in later referrals for specialist care and also sometimes causing chronic kidney disease (CKD) to be hidden on lab reports and shown as “normal” (Fly under the radar) in Black people even though they are 3.5 times more likely than White persons to have kidney failure.
For example, 2 blood tubes are sent to the lab with the same sample, from a male, age (75) and creatinine (1.3mg/dL):
- Tube 1 is labeled: Race White and
- Tube 2 is labeled: Race Black
The GFR for Tube 1 would be reported as 57 and Stage 3A CKD and therefore trigger action for further medical care…
But the GFR for Tube 2 would be reported as 69 and therefore show as normal even though the SAME sample was used for both tubes. The lab and the provider do not know that the person who gave the sample has urine positive for blood and protein because no urine sample was sent. Therefore with the race modifier calculation of GFR, Black patients were having their kidney disease detected later and receiving delayed referrals for kidney care, kidney transplant and preparation for dialysis compared to other races even though the Black race is disproportionately more affected by kidney failure (at higher rates).
The process of ensuring that lab reports no longer show a race-modified GFR for African-American/Black race is going to take some time so you may still see a GFR number with race modifier on your lab report until the entire health system is aware of and implements the new recommendations. In the interim, read more about the controversy by clicking here to visit The National Kidney Foundation’s site!
If you want to understand more about your GFR, visit our page “Understanding Your Kidney Blood Test: 3 Important Things to Know.”