Your Kidneys Don't Lie - But the Formula Did

For years, widely used eGFR equations included a race variable for patients classified as Black. That adjustment could raise the estimated kidney-function number, making some Black patients appear to have better kidney function than a comparable calculation without the race factor.

Race was built into the calculation

eGFR estimates how well the kidneys filter waste from the blood. The National Kidney Foundation and American Society of Nephrology recommended a new race-free CKD-EPI equation in 2021 after growing concern that race is a social classification, not a direct biological measure of kidney function.

The transplant system also moved to prohibit race-inclusive eGFR calculations for transplant evaluation.

The consequence became measurable

The Organ Procurement and Transplantation Network created a process to restore waiting time for Black kidney candidates whose eligibility had been delayed by race-inclusive eGFR. HRSA reported 14,701 waiting-time modifications in the first year of the policy, with a median 1.7 years restored.

That is not an abstract correction. Waiting time is one of the factors used to prioritize kidney offers.

What patients should take from this

Patients do not need to calculate eGFR themselves. They can ask which equation a health system uses, whether historical race-based calculations affected their record and, for transplant candidates, whether the program reviewed eligibility for a waiting-time modification.

This article is general health information, not a diagnosis or individual medical advice. Questions about kidney function belong with a clinician or transplant team that can review a patient's actual labs and history.