A person undergoing dialysis for a kidney condition Science Photo Library
A controversial recommendation to adjust kidney test results based on a person鈥檚 ethnicity has been removed from UK medical guidance.
Kidney function is routinely assessed using an equation that estimates the rate at which a person鈥檚 kidneys filter waste, known as their estimated glomerular filtration rate (eGFR). Until 25 August, guidelines from the UK鈥檚 National Institute for Health and Care Excellence (NICE) recommended applying 鈥渁 correction factor to GFR values鈥 for people of African-Caribbean or African family origin鈥. In an , this recommendation to adjust eGFR based on ethnicity has been removed.
The updated NICE guidance comes as a growing number of doctors and researchers have been questioning the use of race and ethnicity adjustments in medical tests, and highlighting the lack of evidence to support their use and the potential harm they can cause.
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A led by and at King鈥檚 College Hospital in London found that the use of ethnicity adjustment in eGFR equations overestimates actual GFR in Black people by about 25 per cent. This may lead to reduced diagnosis of chronic kidney disease and underestimation of disease severity among Black people in the UK, they concluded.
鈥淲e welcome and support this change and are encouraging all renal services to work with clinical laboratories and/or electronic clinical system developers to remove the adjustment for Black ethnicity from eGFR creatinine reports,鈥 says , president of the UK Kidney Association.
鈥淓thnicity and race are social constructs and do not match genetic categories,鈥 he says. 鈥淎djusting for kidney function based on ethnicity could lead to an overestimation of kidney function and potential inequality in delivery of care.鈥
NICE told New 女生小视频: 鈥淭he guideline committee recognised that the estimation of glomerular filtration rate (GFR) should no longer be adjusted for people of African-Caribbean or African family origin. This was due to a number of variable factors in the evidence which meant it was more appropriate to take into account individual risk factors.鈥
The new guidance recommends that biomarkers be investigated to improve the diagnostic accuracy of eGFR calculations.
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