Updated guidelines expected to lead to earlier interventions and better outcomes
In concert with guidelines provided by the National Kidney Foundation and the American College of Nephrology, CommonSpirit Health has removed race-based algorithms in lab testing for chronic kidney disease.
The launch of the new algorithms marks a significant step towards removing barriers to care that have disproportionately impacted Black, Hispanic and Native Americans, who are more likely to be diagnosed at a later stage because their kidney health has been measured differently.
“We have changed our clinical practice standards in order to establish more equitable measures to guide and ensure earlier diagnosis and treatment of kidney disease, especially for patients for whom traditional clinical standards have fallen short,” said Ankita Sagar, MD, System Vice President for Clinical Standards and Variation Reduction, Physician Enterprise.
Although kidney disease is a common and serious health condition that affects nearly 37 million Americans, diagnosing the disease has not always been straightforward. For decades medical professionals have used an assessment tool called estimated glomerular filtration rate (eGFR) to calculate a variety of factors, including lab test results, age, and race to measure kidney function.
The previous eGFR equation included age, sex, race and/or body weight; however, recent studies have suggested that there is no scientific basis for including race in the algorithm. In fact, doing so can result in care delays and poorer clinical outcomes for Black, Hispanic and Native Americans.
In addition to changing to an equitable algorithm to address this health disparity, CommonSpirit has created the Equity Heals: Addressing Chronic Kidney Disease outreach initiative, which focuses on racial justice-informed, patient and community awareness and education to improve chronic kidney disease outcomes of Black and other communities. The Equity Heals initiative will be implemented in CommonSpirit’s hospitals across the United States.
The eGFR algorithm change was accomplished as a partnership between the Physician Enterprise, lab information services, medical informatics, as well as the Office of Diversity, Equity, Inclusion and Belonging.