There are thousands of Americans suffering from terminal kidney illness and waiting for a new kidney to undergo a transplant operation.
Kidney Experts Push For The Removal Of Racial Factors From Kidney Disease Assessment
However, the majority of these patients are very unlikely to get a new kidney which is more evident for black patients.
The black population although constituting only 13% of the US population, makes up for 35% of the total patient load on dialysis.
Some experts believe it can be attributed to an algorithm used by doctors for the assessment of the disease through all the stages.
Role of race in assessing kidney disease:
In the present times, doctors use an algorithm that considers the race of the patient along with the blood sample while assessing the kidney disease.
The racial factor used in the assessment has recently come under intense scrutiny for being imprecise, that produces even worse outcome for the black patients by almost attaching a social stigma to them.
The practice has already been aborted by a few institutions and a national task force for kidney disease is looking for more efficient alternatives to introduce as a factor for kidney disease assessment.
Why was race introduced in the assessment:
With the question of how to efficiently assess kidney disease still remaining unclear, one more question comes up as to why was race introduced in the algorithm.
Kidneys filter almost 40 gallons of blood in a day, yet they cannot repair themselves with ease like the other organs.
So once the kidneys start faltering it cannot be reversed, states Dr. Cynthia Delgado, a nephrologist at the University of California, San Francisco, and one of the key people leading the task force finding an alternative algorithm for the diagnosis of kidney disease.
The popular test for kidney disease was the gold standard test that evaluated the functioning of the kidney based on hoiw quickly they can flush out the chemical infusion that was introduced to the blood for the purpose of the study.
The doctors also used the Cockcroft-gault equation, which was based on the age of the person rather than his race.
However, researchers later realized that there were abundant data available that can help in rewriting the above equation for a more accurate result.
Hence the data from the gold standard test was obtained which contained data of 1600 patients. Of which 12% were blacks. 16 variables like age, diabetes condition, and blood pressure were evaluated that gave an almost accurate prediction of kidney functionality of patients.
The downside was that it made the kidneys of the black people look more affected than that of the white patients.
The authors of the study attributed it to the muscle mass of an individual, as more muscle mass means more metabolic activities in the body with a higher level of creatinine than the others.
According to the leader of the study, Dr. Andrew S. Levey, also a professor at the Tufts University School of Medicine, states that including race as a variable for assessing kidney disease makes no sense in the modern social structure, it is rather dependant on biology.
Removing the faulty variable:
The inclusion of race in the assessment did not prove to be beneficial for the black patients, it just made the wait longer for referrals, getting an opportunity for transplant, or proper care.
At the moment, Levey and other researchers in the US are looking for more efficient variables like age, height, for replacing the old variable have not found much success.
According to the members of the task force, working on replacing the variable, who is also attached to the John Hopkins University, it is not about something in the body of the black people that are influencing the kidney diseases, rather something in their environment that has an impact on their health.They further explain it as unavailability of quality food, healthcare, and poorly managed chronic health conditions might be the contributory factor rather than skin color, which unfortunately is more common among the black population.