Throughout the U.S., kidney function has been reported for decades in a racially dichotomized fashion, with estimated glomerular filtration (eGFR) rates listed as separate values for “African American” and “non African American” patients. This reporting system has been intensely debated within the nephrology community. Our division has led an NYP-wide effort to implement a new way of reporting eGFR, termed “raceless range” reporting. This change, while not a panacea, avoids the racial bias and inequity that can result from the current reporting system by eliminating the need for clinicians to use patient race.
The revolution in eGFR reporting represents an intersection of epidemiology, public health, medical science, and racial justice. As such, our project aimed to utilize eGFR reporting as a lens through which to initiate community discussions about the use and misuse of race in medicine. For the medical students, this means revising existing curriculum content and creating new materials to fundamentally transform the way we teach eGFR. We collaborated with former and current P&S students to help us implement these changes as well as create a survey to measure our efficacy and define areas for future improvement. For our colleagues across the Medical Center, we view the eGFR reporting change as an opportunity to engage in meaningful discussions about the historical context for eGFR reporting, the rationale for change, the advantages and challenges inherent in the new reporting system, and implications for clinical practice.
This project was funded through the Addressing Racism: A Call to Action for Higher Education initiative of the Office of the Vice Provost for Faculty Advancement.