The Repercussions of Race-Based eGFR on the Morbidity & Mortality of Black Children with Renal Disease

This study investigates the implications of race-based adjustments in estimated glomerular filtration rate (eGFR) calculations on the health outcomes of Black children with renal disease. Historically, a race coefficient has been added to eGFR calculations for patients identified as Black, resulting in an artificial inflation of kidney function by approximately 16%. This inflation can delay the classification of chronic kidney disease (CKD), postpone eligibility for essential interventions like preemptive kidney transplantation, and prolong reliance on maintenance dialysis. Through a comprehensive literature review of peer-reviewed U.S. medical journal articles published between 2000 and 2023, this work explores how these clinical delays may contribute to disproportionate morbidity and mortality among Black pediatric renal patients. While socioeconomic factors confound the full impact of race-based eGFR, evidence suggests that the metric itself—being a physician-controlled variable—represents a modifiable barrier to equitable treatment. The findings underscore the urgent need to reassess and eliminate race-based medical practices in pediatric nephrology and beyond to improve health equity and outcomes.