Med-community bias means black patients get worse kidney disease care: study

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Black patients are more likely to get inadequate treatment for liver disease — because the formula for determining disease severity has a racial bias, a new study has found.

Medical professionals calculate kidney health, in part, by measuring the presence of a waste product called creatinine in the blood system — the more creatinine, the lower patients score on the so-called estimated glomerular filtration rate test.

Lower scores indicating a more imperiled kidney — as the organ is struggling to filter waste from the patient’s blood.

But past studies that have concluded that black patients tend to have have higher creatinine levels on average due to differences in muscle mass, diets, and other factors — leading doctors artificially inflate black patients’ eGFR scores in an attempt to balance the results, according to the National Kidney Foundation.

That measure has increasingly come under fire as more recent studies found that creatinine levels fluctuate in adults regardless of race or ethnicity — particularly as the number of multi-racial Americans increase, the University of Washington said in a report in May.

Now the new study, which was performed by Boston-area researchers, determined that 1/3 of black patients would have qualified for higher levels of care — and in some cases for kidney transplants — if race was not factored into the algorithm used to assess their condition.

The report in the Journal of General Internal Medicine concluded that the algorithm had “a meaningful impact” on the treatment of black patients.

The study examined health records for nearly 57,000 people suffering from chronic kidney disease in the Mass General Brigham health system, a group that includes Harvard University teaching hospitals in Massachusetts, Wired said in a report.

The study group included 2,225 black patients and found that 743 of them would likely be reclassified in a more severe stage of the disease — while 64 would have qualified to be added to a transplant wait list, the study said.

“That was really staggering,” Mallika Mendu, an assistant professor at Harvard Medical School, told Wired. “We know there are already other disparities in access to care and management of the condition. This is not helping.”

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