Race, Genetic Ancestry, and Estimating Kidney Function in CKD
Year: 2021
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The inclusion of race in equations to estimate the glomerular filtration rate (GFR) has become controversial. Alternative equations that can be used to achieve similar accuracy without the use of race are needed. METHODS: In a large national study involving adults with chronic kidney disease, we conducted cross-sectional analyses of baseline data from 1248 participants for whom data, including the following, had been collected: race as reported by the participant, genetic ancestry markers, and the serum creatinine, serum cystatin C, and 24-hour urinary creatinine levels. RESULTS: , 41%; 95% CI, 34 to 49) estimates in Black participants when GFR was estimated with the use of cystatin C. CONCLUSIONS: The use of the serum creatinine level to estimate the GFR without race (or genetic ancestry) introduced systematic misclassification that could not be eliminated even when numerous non-GFR determinants of the serum creatinine level were accounted for. The estimation of GFR with the use of cystatin C generated similar results while eliminating the negative consequences of the current race-based approaches. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others.).
Source: New England Journal of Medicine
Authors: Chi-yuan Hsu, Wei Yang, Rishi V. Parikh, Amanda H. Anderson, Teresa K. Chen, Debbie L. Cohen, Jiang He, Madhumita J. Mohanty, James P. Lash, Katherine T. Mills, Anthony N. Muiru, Afshin Parsa, Milda R. Saunders, Tariq Shafi, Raymond R. Townsend, Sushrut S. Waikar, Jianqiao Wang, Myles Wolf, Thida C. Tan, Harold I. Feldman, Alan S. Go
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Clinical and Translational Science Institute, American Indian Chronic Renal Insufficiency Cohort Study (AI-CRIC), Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study, General Clinical Research Center, Center for Clinical and Translational Science, Michigan Institute for Clinical and Health Research (MCHR), Institute for Clinical and Translational Research, Institutional Clinical and Translational Science Award, Using predictive analytics to tailor care for patients with newly diagnosed type 2 diabetes, Clinical and Translational Science Collaborative of Cleveland, Tulane COBRE for Clinical and Translational Research in Cardiometabolic Diseases, A pilot trial of an intervention to support initial type 2 diabetes selfmanagement among younger adults with children., Prospective renal insufficiency cohort evaluation: PRICE, Chronic Renal Insufficiency Cohort (CRIC) Study Clinical Center, Continuation of the Chronic Renal Insufficiency Cohort (CRIC), SEARCH-CKD: The nature of chronic kidney disease and elevated blood pressure in sub-Saharan Africa., Continuation of the University of Illinois Chicago CRIC Clinical Center, Limited Competition for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Hopkins Clinical Center, Tulane Clinical Center for Chronic Renal Insufficiency Cohort Study, Chronic Renal Insufficiency Cohort Limited competition continuation, Chronic Renal Insufficiency Cohort (CRIC) Study
OpenAlex ID: W3200414192