ASN and NKF Commend Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases

In a joint statement, the American Society of Nephrology (ASN) and the National Kidney Foundation (NKF) commended the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases for submitting its final report for publication. 

“On behalf of the leadership of NKF and ASN, we are excited for the kidney community—as well as other stakeholders, particularly the medical students, residents, and fellows who have spearheaded the call to action on this important issue—to consider the task force’s recommendations for how best to remove race modifiers from the assessment of kidney function,” begins the statement. “Additionally, we thank each member of the task force for their remarkable effort, thoughtfulness, and cooperation in completing their charge.”

The task force previously published “Special Article: Reassessing the Inclusion of Race in Diagnosing Kidney Diseases: An Interim Report from the NKF-ASN Task Force” in the Journal of the American Society of Nephrology (JASN) and the American Journal of Kidney Diseases (AJKD). The interim report provides an essential review of the many challenges relative to identifying and implementing alternative methods for diagnosing kidney diseases. Covering the process, initial assessment of evidence, and values defined concerning the use of race to estimate glomerular filtration rate (GFR), it is organized into three phases: clarifying the problem and examining evidence, evaluating different approaches to address use of race in GFR estimation, and making  recommendations. 

“In phase 1, we constructed statements about the evidence and defined values regarding equity and disparities; race and racism; GFR measurement, estimation, and equation performance; laboratory standardization; and patient perspectives,” the interim report explains. “We also identified several approaches to estimate GFR and a set of attributes to evaluate these approaches. Building on evidence and values, the attributes of alternative approaches to estimate GFR will be evaluated in the next phases and recommendations will be made.”

In addition to the task force’s interim report, NKF and ASN set forth the following objectives:

  • Equations to estimate kidney function should not include race modifiers.
  • Current race-based equations should be replaced by a suitable approach that is accurate, inclusive, and standardized in every laboratory in the United States.
  • Any such approach must not differentially introduce bias, inaccuracy, or inequalities.

The final report is currently under review. “Once the final report is published and publicly available, we look forward to laboratories, institutions, and other entities adopting this equation to provide a harmonized, race-free estimation of kidney function,” the statement reads. ASN and NKF praised the task force for ensuring its final report aligns with these objectives and anticipate distributing it to the kidney community and other stakeholders as part of a broader implementation strategy. They also encouraged the Kidney Disease Outcomes Quality Initiative (KDOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) to develop updated guidelines that ensure a uniform approach consistent with the task force’s recommendations.

“While the task force efforts represent an important first step in the work of NKF, ASN, and the rest of the kidney community to address racism in nephrology, there is still much more to be done to eliminate racial disparities in kidney health and in the care of persons with kidney diseases,” the statement points out.