Medica Urges Providers to Stop Using Race Adjustment When Estimating Kidney Function
Medica joins medical societies and leading health care organizations to reduce racial disparities in kidney care.
MINNETONKA, Minn. – Medica is committed to ensuring that everyone receives equitable health care, and is asking its network of providers to change the way they treat kidney disease.
Through its clinical guidelines, Medica is encouraging quality, equitable patient care by recommending providers discontinue the most common method used by health professionals to diagnose and assess the severity of kidney disease, which is estimated glomerular filtration rate (eGFR).
Most health care providers calculate an estimated GFR – or eGFR – that assumes Black people generally have higher baseline levels of serum creatinine and therefore adjusts their scores upward.
As a result, this method can overestimate kidney function in people with African ancestry, which causes delays in referrals for specialist care and kidney transplants, and can lead to worse health outcomes. According to the National Kidney Foundation, Black Americans are about three times more likely to develop kidney failure than white Americans. In addition, they are less likely to receive a transplant evaluation, have less access to the waitlist, spend longer on the waitlist, are less likely to survive on the waitlist, and have lower rates of transplant success.
“Our mission is to earn the trust of those we serve, and with that comes our commitment to being an active ally and advocate for changes that help make the lives of all people healthier and happier,” said John Mach, M.D., Medica’s Chief Medical Officer and Senior Vice President. “Using race as a factor when estimating kidney health is imprecise and disproportionately puts Black Americans at risk for severe health complications that could otherwise be treated.”
Medica’s Medical Policy Committee, which is composed of credentialed Medica-network physicians representing a range of medical disciplines, voted unanimously to adopt a new clinical guideline that recommends network providers use either a direct measure of GFR or another method of estimating GFR using serum cystatin C, which does not involve consideration of race.
“By changing our guidelines to encourage our network providers to use an alternative method of estimating GFR without consideration of race, Medica is aligning with leading advocates for the advancement of equity in kidney care,” said Dr. Mach.
Resources:
New England Journal of Medicine – August 27, 2020: Hidden in Plain Sight – Reconsidering the Use of Race Correction in Clinical Algorithms
National Kidney Foundation (kidney.org) – August 17, 2021: Understanding why eGFR laboratory results include African American and non-African American results