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• W3152986545 abstract "For almost 2 decades, equations that use serum creatinine, age, sex, and race to estimate glomerular filtration rate (GFR) have included “race” as Black or non-Black. Given considerable evidence of disparities in health and health care delivery in African American communities, some regard keeping a race term in GFR equations as a practice that differentially influences access to care and kidney transplantation. Others assert that race captures important non-GFR determinants of serum creatinine and its removal from the calculation may perpetuate other disparities. The National Kidney Foundation (NKF) and American Society of Nephrology (ASN) established a task force in 2020 to reassess the inclusion of race in the estimation of GFR in the United States and its implications for diagnosis and subsequent management of patients with, or at risk for, kidney diseases. This interim report details the process, initial assessment of evidence, and values defined regarding the use of race to estimate GFR. We organized activities in phases: (1) clarify the problem and examine evidence, (2) evaluate different approaches to address use of race in GFR estimation, and (3) make 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. 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. For almost 2 decades, equations that use serum creatinine, age, sex, and race to estimate glomerular filtration rate (GFR) have included “race” as Black or non-Black. Given considerable evidence of disparities in health and health care delivery in African American communities, some regard keeping a race term in GFR equations as a practice that differentially influences access to care and kidney transplantation. Others assert that race captures important non-GFR determinants of serum creatinine and its removal from the calculation may perpetuate other disparities. The National Kidney Foundation (NKF) and American Society of Nephrology (ASN) established a task force in 2020 to reassess the inclusion of race in the estimation of GFR in the United States and its implications for diagnosis and subsequent management of patients with, or at risk for, kidney diseases. This interim report details the process, initial assessment of evidence, and values defined regarding the use of race to estimate GFR. We organized activities in phases: (1) clarify the problem and examine evidence, (2) evaluate different approaches to address use of race in GFR estimation, and (3) make 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. 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. Editorial, p. 3 Editorial, p. 3 The measurement of creatinine, the muscle protein metabolite, in serum is used to estimate kidney function as estimated glomerular filtration rate (eGFR) and has served as a major marker for the detection, diagnosis, and management of kidney diseases. Creatinine-based eGFR (eGFRcr) thresholds guide clinical practice, including estimation of surgical complication risk; initiation, discontinuation, and dosing of medications; and utilization of certain contrast-based tests and procedures, such as computed tomography scans or cardiac catheterizations. Almost all clinical laboratories in the United States now report eGFR with any laboratory metabolic panel that contains serum creatinine, with one estimate for African Americans and another for non–African Americans.1Miller W.G. Jones G.R.D. Estimated glomerular filtration rate; laboratory implementation and current global status.Adv Chronic Kidney Dis. 2018; 25: 7-13Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar Use of race in medical practice has come under scrutiny in light of the most recent reckoning with racism and publicly displayed atrocities against racial and ethnic minorities across the United States that has been longstanding. On a national scale, eGFR is used for important surveillance and regulatory purposes, including population tracking of kidney diseases by the Centers for Disease Control and Prevention and the US Renal Data System, research supported by the National Institutes of Health (NIH) and other public and private funding agencies (including ongoing clinical trials), and eligibility for kidney disease education or nutritional supplementation under the Medicare program.2Centers for Disease Control (CDC)Chronic Disease Surveillance System—United States.https://nccd.cdc.gov/CKD/default.aspxGoogle Scholar, 3Williams M.E. Chianchiano D. Medicare medical nutrition therapy: Legislative process and product.J Ren Nutr. 2002; 12: 1-7Abstract Full Text Full Text PDF PubMed Google Scholar, 4Centers for Medicare and Medicaid Services (CMS)Kidney disease education.https://www.medicare.gov/coverage/kidney-disease-educationGoogle Scholar, 5United States Renal Data Systemhttps://www.usrds.orgGoogle Scholar Although GFR estimation has remained an important guide for clinical decision making and population tracking, derived equations, like many other tools in medicine, have undergone a nearly 50-year history of re-evaluation, adaptation, and refinement. This evolution continues in the reassessment of the use of race in estimating GFR. Since 1976, equations developed to estimate the clearance or filtration function of the kidney from serum creatinine concentration have included, and adjusted for, various factors, including age, sex, African American race, and/or body weight. These equations were largely developed using clinical, epidemiologic, and statistical methods that were, at the time of equation derivation, considered to be scientifically state of the art. The Cockcroft-Gault equation, one of the initial equations, used data from 249 White men with measured creatinine clearance ranging from 30 to 130 mL/m2 to estimate creatinine clearance.6Cockcroft D.W. Gault M.H. Prediction of creatinine clearance from serum creatinine.Nephron. 1976; 16: 31-41Crossref PubMed Scopus (12622) Google Scholar Although this equation represents one of the initial attempts to approximate kidney function without needing to undergo laborious and potentially incomplete urine collection, the derivation cohort was limited by lack of both race and sex diversity. After the publication and use of the Cockcroft-Gault equation and before the derivation of subsequent equations, published research by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) showed that serum creatinine concentrations were higher among non-Hispanic Black adults when compared with non-Hispanic White adults.7Jones C.A. McQuillan G.M. Kusek J.W. et al.Serum creatinine levels in the US population: Third National Health and Nutrition Examination Survey.Am J Kidney Dis. 1998; 32: 992-999Abstract Full Text PDF PubMed Scopus (459) Google Scholar This research was based on the Third National Health and Nutrition Examination Survey, a nationally representative sample of the US population. Subsequent research by Levey and others found that serum creatinine levels were higher among African American adults who had the same measured GFR as their White adult counterparts, indicating that determinants of serum creatinine levels, other than GFR, differed between the groups.8Levey A.S. Bosch J.P. Lewis J.B. Greene T. Rogers N. Roth D. Modification of Diet in Renal Disease Study Group. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation.Ann Intern Med. 1999; 130: 461-470Crossref PubMed Scopus (12412) Google Scholar Race was among the 16 factors considered in the derivations and refinement of the Modification of Diet in Renal Disease (MDRD) Study equation reported in 1999.8Levey A.S. Bosch J.P. Lewis J.B. Greene T. Rogers N. Roth D. Modification of Diet in Renal Disease Study Group. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation.Ann Intern Med. 1999; 130: 461-470Crossref PubMed Scopus (12412) Google Scholar In regression models to predict GFR from serum creatinine levels, a term (and coefficient) for self-identified African American race was found to be a substantial and statistically significant predictor of carefully measured GFR.8Levey A.S. Bosch J.P. Lewis J.B. Greene T. Rogers N. Roth D. Modification of Diet in Renal Disease Study Group. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation.Ann Intern Med. 1999; 130: 461-470Crossref PubMed Scopus (12412) Google Scholar The MDRD Study equation was validated in the African American Study of Kidney Disease and Hypertension.9Lewis J. Agodoa L. Cheek D. et al.African American Study of Hypertension and Kidney Disease: Comparison of cross-sectional renal function measurements in African Americans with hypertensive nephrosclerosis and of primary formulas to estimate glomerular filtration rate [published correction appears in Am J Kidney Dis 39: 444, 2002].Am J Kidney Dis. 2001; 38: 744-753Abstract Full Text Full Text PDF PubMed Scopus (188) Google Scholar At the time, this adjustment was thought to be an advance because an important group, with high risk for CKD progression, was included in studies of measured GFR. In 2009, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation using creatinine was developed in a subsequent analysis with pooled studies of individual participants. Meta-analytic regression was used in a more heterogeneous participant population, which combined data from thousands of individuals (including White, African American, and—to a far lesser extent—Asian, Hispanic/Latinx, and Native American individuals) from 10 different independent studies. Results were validated in a pooled group of 16 separate studies.10Levey A.S. Stevens L.A. Schmid C.H. et al.A new equation to estimate glomerular filtration rate [published correction appears in Ann Intern Med 155: 408, 2011].Ann Intern Med. 2009; 150: 604-612Crossref PubMed Scopus (13304) Google Scholar Across these studies, investigators found a similar result for African American race as a predictor of measured GFR, with the magnitude of the coefficient slightly less than that in the MDRD Study equation (1.20 compared with White individuals for the MDRD Study equation, and 1.16 compared with non-Black individuals for the CKD-EPI equation). In studies of measured GFR in the United States, other racial and ethnic groups were not included in large-enough numbers to understand whether differences in non-GFR determinants of creatinine are present in persons of non-White and non-Black race or ethnicity.11Stevens L.A. Claybon M.A. Schmid C.H. et al.Evaluation of the Chronic Kidney Disease Epidemiology Collaboration equation for estimating the glomerular filtration rate in multiple ethnicities.Kidney Int. 2011; 79: 555-562Abstract Full Text Full Text PDF PubMed Scopus (274) Google Scholar An alternative filtration marker, cystatin C, is available and does not include race in its estimating equation for GFR. Estimated GFR from cystatin C is not more accurate than eGFRcr; however, the equation reported in 2012, with a combination of the 2 markers, provides more accurate estimates.12Inker L.A. Schmid C.H. Tighiouart H. et al.CKD-EPI Investigators: Estimating glomerular filtration rate from serum creatinine and cystatin C [published correction appears in N Engl J Med 367: 2060, 2012].N Engl J Med. 2012; 367: 20-29Crossref PubMed Scopus (2080) Google Scholar A term for African American race is included in this combined marker equation that is substantially smaller than in the creatinine-only equations (1.08). In the report of the equation, the investigators noted an insufficient number of African Americans were included in the validation datasets, prohibiting validation of the effect of this coefficient in a separate population outside of the development population. Clinical practice guidelines from KDIGO (Kidney Disease: Improving Global Outcomes) recommend that, whenever serum creatinine is measured in clinical practice, an eGFR should be reported with an eGFRcr, using the CKD-EPI 2009 creatinine equation or a similarly accurate equation. When a more accurate assessment of GFR is required, or there are concerns about the accuracy of eGFRcr, this initial test should be followed by a confirmatory test using eGFR computed by cystatin C (alone or in combination with creatinine), measured creatinine clearance, or measured GFR.13Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work GroupKDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease.Kidney Int Suppl. 2013; 3: 1-150Abstract Full Text Full Text PDF Scopus (1246) Google Scholar Since the first eGFR equations were introduced 2 decades ago, data from laboratories in the United States show continual growth in the reporting of eGFR along with serum creatinine and, despite KDIGO guidelines, the MDRD Study equation is the most frequently used.14College of American Pathologists; Clinical Chemistry CommitteeKidney biomarkers: the kidney profile order, urine albumin creatinine ratio (uACR), and estimated glomerular filtration rate (eGFR).https://documents.cap.org/documents/2020-a-kidney-biomarkers.pdfDate: 2020Google Scholar Although the biological rationale for including coefficients (such as age, sex, and body weight) in eGFR equations seem apparent, the reasons for including race on the basis of serum creatinine observational data, muscle mass, and/or other factors are questionable.15Braun L. Wentz A. Baker R. Richardson E. Tsai J. Racialized algorithms for kidney function: Erasing social experience.Soc Sci Med. 2021; 268: 113548Crossref PubMed Scopus (7) Google Scholar It may be problematic to rely on a correction without completely understanding what factors are being captured together, and with an underappreciation of the ancestral diversity among African Americans that also exists in other racial and ethnic groups.16Zakharia F. Basu A. Absher D. et al.Characterizing the admixed African ancestry of African Americans.Genome Biol. 2009; 10: R141Crossref PubMed Scopus (103) Google Scholar There is well-known exploitation and inhumane experimentation to which racial and ethnic minority individuals, particularly African Americans, have been subjected.17Borrell L.N. Elhawary J.R. Fuentes-Afflick E. et al.Race and genetic ancestry in medicine - a time for reckoning with racism.N Engl J Med. 2021; 384: 474-480Crossref PubMed Scopus (25) Google Scholar As a small, but growing, number of US individuals self-identify as being of mixed racial background, the complexity of a changing racial and ethnic composition makes the use of race in the practice of medicine further problematic. Recent calls for social justice reform have galvanized segments of the medical community into further discourse and action toward achieving greater health care equity, including the assertion of race as a social, nonbiological, construct.18Vyas D.A. Eisenstein L.G. Jones D.S. Hidden in plain sight – reconsidering the use of race correction in clinical algorithms.N Engl J Med. 2020; 383: 874-882Crossref PubMed Scopus (225) Google Scholar, 19Borrell L.N. Elhawary J.R. Fuentes-Afflick E. et al.Race and genetic ancestry in medicine—A time for reckoning with racism.N Engl J Med. 2021; 384: 474-480Crossref PubMed Scopus (49) Google Scholar, 20Cerdeña J.P. Plaisime M.V. Tsai J. From race based to race-conscious medicine: How antiracist uprisings call us to act.Lancet. 2020; 396: 125-1128Abstract Full Text Full Text PDF Scopus (38) Google Scholar, 21Oni-Orisan A. Mavura Y. Banda Y. Thornton T.A. Sebro R. Embracing genetic diversity to improve Black health [published online ahead of print February 10, 2021]. N Engl J Med.https://doi.org/10.1056/NEJMms2031080Google Scholar, 22Ioannidis J.P.A. Powe N.R. Yancy C. Recalibrating the use of race in medical research.JAMA. 2021; 325: 623-624Crossref PubMed Scopus (28) Google Scholar, 23Roberts D.E. Abolish race correction.Lancet. 2021; 397: 17-18Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar, 24Roberts D.E. Is race-based medicine good for us?: African American approaches to race, biomedicine, and equality.J Law Med Ethics. 2008; 36: 537-545Crossref PubMed Scopus (40) Google Scholar Many assert that removing race from estimating GFR would achieve better health and health care equity by mitigating disparities, particularly for African American patients who experience faster progression to kidney failure and lower rates of transplantation. This rationale posits that such a change would result in earlier identification and management of kidney diseases for African American patients, referral for specialist care by nephrologists, and earlier referral for kidney transplantation.25Grubbs V. Precision in GFR reporting: Let’s stop playing the race card.Clin J Am Soc Nephrol. 2020; 15: 1201-1202Crossref PubMed Scopus (23) Google Scholar, 26Eneanya N.D. Yang W. Reese P.P. Reconsidering the consequences of using race to estimate kidney function.JAMA. 2019; 322: 113-114Crossref PubMed Scopus (94) Google Scholar, 27Ahmed S. Nutt C.T. Eneanya N.D. et al.Examining the potential impact of race multiplier utilization in estimated glomerular filtration rate calculation on African-American care outcomes.J Gen Intern Med. 2021; 36: 464-471Crossref PubMed Scopus (28) Google Scholar Others assert that, even if previously observed racial differences are poorly understood, race is capturing important determinants of estimated GFR. This rationale posits that removing race may create or perpetuate other disparities by assigning the value for non–African Americans to African Americans.17Borrell L.N. Elhawary J.R. Fuentes-Afflick E. et al.Race and genetic ancestry in medicine - a time for reckoning with racism.N Engl J Med. 2021; 384: 474-480Crossref PubMed Scopus (25) Google Scholar,28Powe N.R. Black kidney function matters: Use or misuse of race?.JAMA. 2020; 324: 737-738Crossref PubMed Scopus (41) Google Scholar,29Diao J.A. Wu G.J. Taylor H.A. et al.Clinical implications of removing race from estimates of kidney function.JAMA. 2021; 325: 184-186Crossref PubMed Scopus (1) Google Scholar There is also a concern of subjectivity in regards to applying the African American race coefficient on health care decision making, and personal and/or provider bias in transparency with patient-physician communication. These points of view, along with others, have highlighted the need to find an approach to GFR estimation that embraces the substantial diversity of the US population and promotes social and health equity without creating new, or worsening current, health disparities. Studies have shown disparities in health and health care disproportionately affect African Americans. When compared with non-Hispanic White individuals, African Americans have nearly double the prevalence of hypertension, a common etiology of kidney disease.30Keenan N.L. Rosendorf K.A. Centers for Disease Control and Prevention (CDC)Prevalence of hypertension and controlled hypertension – United States, 2005–2008.MMWR Suppl. 2011; 60: 94-97PubMed Google Scholar, 31Gillespie C.D. Hurvitz K.A. Centers for Disease Control and Prevention (CDC)Prevalence of hypertension and controlled hypertension – United States, 2007–2010.MMWR Suppl. 2013; 62: 144-148PubMed Google Scholar, 32Fryar C.D. Ostchega Y. Hales C.M. Zhang G. Kruszon-Moran D. Hypertension prevalence and control among adults: United States, 2015–2016.NCHS Data Brief. 2017; : 1-8Google Scholar Decline in GFR among African Americans occurs at an earlier age and at a faster annualized rate when compared with non-Hispanic White Americans, even by cystatin C–based GFR assessment.33Peralta C.A. Vittinghoff E. Bansal N. et al.Trajectories of kidney function decline in young black and white adults with preserved GFR: Results from the Coronary Artery Risk Development in Young Adults (CARDIA) study.Am J Kidney Dis. 2013; 62: 261-266Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar African Americans with advanced kidney disease are younger, with an incidence of kidney failure nearly 3 times that of their non-Hispanic White counterparts.5United States Renal Data Systemhttps://www.usrds.orgGoogle Scholar Such disparities go beyond the burden of kidney diseases and extend into differences in kidney disease treatment. Before the widespread use of GFR estimation, it was documented that African Americans were more likely to receive a late referral for an evaluation by a nephrologist, a finding that is associated with decreased survival after the development of kidney failure.34Kinchen K.S. Sadler J. Fink N. et al.The timing of specialist evaluation in chronic kidney disease and mortality.Ann Intern Med. 2002; 137: 479-486Crossref PubMed Scopus (385) Google Scholar As documented since the 1980s and 1990s, African Americans are less likely to be treated with home dialysis therapies and to be waitlisted for kidney transplant, with even fewer being transplanted.5United States Renal Data Systemhttps://www.usrds.orgGoogle Scholar,35Barker-Cummings C. McClellan W. Soucie J.M. Krisher J. Ethnic differences in the use of peritoneal dialysis as initial treatment for end stage renal disease.JAMA. 1995; 274: 1858-1862Crossref PubMed Scopus (44) Google Scholar, 36Mehrotra R. Soohoo M. Rivara M. et al.Racial and ethnic disparities in use of and outcomes with home dialysis in the United States.J Am Soc Nephrol. 2016; 27: 2123-2124Crossref PubMed Scopus (39) Google Scholar, 37Eggers P.W. Racial differences in access to kidney transplantation.Health Care Financ Rev. 1995; 17: 89-103PubMed Google Scholar, 38Purnell T.S. Luo X. Cooper L.A. et al.Association of race and ethnicity with live donor kidney transplantation in the United States from 1995 to 2014.JAMA. 2018; 319: 49-61Crossref PubMed Scopus (102) Google Scholar The reasons for observed disparities are multifactorial and may be attributed to internalized, personal, or institutionalized racism.39Bignall 2nd, O.N.R. Crews D.C. Stony the road we trod: Towards racial justice in kidney care.Nat Rev Nephrol. 2021; 17: 79-80Crossref PubMed Scopus (3) Google Scholar,40Jones C.P. Levels of racism: A theoretic framework and a gardener’s tale.Am J Public Health. 2000; 90: 1212-1215Crossref PubMed Scopus (934) Google Scholar To date, disparities in health and health care have not been conclusively attributed to race correction in eGFR equations, although research is ongoing. Whereas Medicare spends approximately $120 billion annually on people with kidney diseases (including >$70 billion for people with kidney disease not requiring kidney replacement therapy), the NIH budget on kidney research is less than $700 million, and little has been allocated to the understanding of racial disparities in kidney disease care and outcomes.5United States Renal Data Systemhttps://www.usrds.orgGoogle Scholar,41National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Budget and legislative information.https://www.niddk.nih.gov/about-niddk/budgetlegislative-informationGoogle Scholar Reassessing race in eGFR should be the start of reassessing race in other areas of diagnosis and management decisions related to kidney disease. Multifaceted initiatives beyond an examination of GFR estimating equations are important to address, and ultimately eliminate, disparities. The National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) announced on July 2, 2020 plans to establish a task force to reassess the inclusion of race in diagnosing kidney disease. Representing patients, health care professionals, and other advocates across the world,42American Society of Nephrology (ASN); National Kidney Foundation (NKF)Establishing a task force to reassess the inclusion of race in diagnosing kidney disease.https://www.kidney.org/news/establishingtask-force-to-reassess-inclusion-racediagnosing-kidney-diseasesGoogle Scholar NKF and ASN are 2 leading organizations dedicated to preventing, treating, and ultimately curing kidney disease. During the past 2 decades, both organizations have championed health equity and health care disparities in kidney disease. The formation of the joint task force is a strong affirmation of both organizations’ commitment to health equity, diversity, and scientific evidence. A decision to remove race from the estimation of GFR is not trivial and could have consequences. As such, NKF and ASN charged the task force with:•Examining the inclusion of race in the estimation of GFR and its implications for the diagnosis and subsequent management of patients with, or at risk for, kidney disease.•Recognizing that any change in eGFR reporting must consider the multiple social and clinical implications, be based on rigorous science, and be part of a national conversation about uniform reporting of eGFR across health care systems.•Incorporating the concerns of patients and the public, especially in marginalized and disadvantaged communities, while rigorously assessing the underlying scientific and ethical issues embedded in current practice.•Ensuring that GFR estimation equations provide an unbiased assessment of GFR so that laboratories, clinicians, patients, and public health officials can make informed decisions to ensure equity and personalized care for patients with kidney disease.•Keeping laboratories, clinicians, and other kidney health professionals apprised of any potential long-term implications of removing race from the eGFR formula. The task force was created to include a variety of health professionals and patients, including individuals with expertise in diagnosis, management, and treatment of kidney disease; measurement and estimation of GFR; health care disparities; epidemiology and clinical research; laboratory medicine; pharmacy; health services research; patient safety; patient experience with care; patient quality of life; medical education; and prevention/public health. The NKF and ASN leadership selected the cochairs and initial members, recognizing the need for various perspectives and backgrounds, requisite expertise, interest, and ability to commit to the intensive deliberations that lie ahead. The cochairs additionally suggested to NKF and ASN that they appoint patients, an expert in drug dosing and US Food and Drug Administration (FDA) considerations, and an expert on public health surveillance. Patients were explicitly included as members because of the importance of their voice and the effects any potential change could have on their health and well-being. Task force members are not remunerated. Disclosures are included in the Article Information at the end of this report. During the initial meeting of the task force, members stated their familiarity and involvement with the issues and biases so that other members of the task force were aware of individual initial leanings. The task force then established principles to guide its interactions and deliberations, including: (1) embracing a holistic approach that examines the clinical, psychosocial, and financial tradeoffs of benefits and harms, balancing them across racial/ethnic groups with particular attention to how kidney diseases affect different races; (2) being data driven and generating a solution driven by science and evidence; and (3) engaging in effective listening, respecting different ideas and opinions, and having a willingness to learn after hearing all perspectives. Importantly, the NKF-ASN leadership and the members of the task force collectively agreed on the confidentiality of deliberations (including refraining from social media commentary) to promote candid opinions and exchange of ideas. Members also mutually agreed to work toward the goal of agreement in instances where there were differences of opinion. All task force weekly sessions were held virtually due to social distancing directives during the coronavirus disease 2019 pandemic. To undertake a comprehensive and in-depth exploration of several issues germane to race and GFR estimation, the task force organized its activities into 3 phases (Box 1). This interim report focuses on phase 1.Box 1Overview of Work Phases and Activities of the NKF-ASN Task ForcePhase 1•Clarifying the problem and evidence◇eGFR and measurement•Race, racism, and genetic ancestry◇Body composition and populations used in GFR estimation◇Standardization and guidelines◇Patients’ perspective and shared decision making•Possible approaches to address race in GFR estimation (Box 3)Phase 2•Evaluating the approaches◇Clinical consequences of different approaches◇System and societal consequences of different approachesPhase 3•Making recommendations◇Issuance of recommendations◇Comment on recommendations◇Implementation Phase 1•Clarifying the problem and evidence◇eGFR and measurement•Race, racism, and genetic ancestry◇Body composition and populations used in GFR estimation◇Standardization and guidelines◇Patients’ perspective and shared decision making•Possible approaches to address race in GFR estimation (Box 3) Phase 2•Evaluating the approache" @default.
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• W3152986545 title "Reassessing the Inclusion of Race in Diagnosing Kidney Diseases: An Interim Report From the NKF-ASN Task Force" @default.
• W3152986545 cites W1550111394 @default.
• W3152986545 cites W1551388977 @default.
• W3152986545 cites W1636328530 @default.
• W3152986545 cites W1918826015 @default.
• W3152986545 cites W1977364749 @default.
• W3152986545 cites W1995298428 @default.
• W3152986545 cites W1995980728 @default.
• W3152986545 cites W2003317275 @default.
• W3152986545 cites W2023742679 @default.
• W3152986545 cites W2029405758 @default.
• W3152986545 cites W2031772671 @default.
• W3152986545 cites W2051208577 @default.
• W3152986545 cites W2051236746 @default.
• W3152986545 cites W2055864845 @default.
• W3152986545 cites W2058716006 @default.
• W3152986545 cites W2066160848 @default.
• W3152986545 cites W2075281490 @default.
• W3152986545 cites W2076212574 @default.
• W3152986545 cites W2078010417 @default.
• W3152986545 cites W2101633780 @default.
• W3152986545 cites W2103744215 @default.
• W3152986545 cites W2118625269 @default.
• W3152986545 cites W2122855609 @default.
• W3152986545 cites W2128632384 @default.
• W3152986545 cites W2129126838 @default.
• W3152986545 cites W2132585345 @default.
• W3152986545 cites W2135636054 @default.
• W3152986545 cites W2135774299 @default.
• W3152986545 cites W2138649409 @default.
• W3152986545 cites W2145172939 @default.
• W3152986545 cites W2147619266 @default.
• W3152986545 cites W2154923317 @default.
• W3152986545 cites W2155965977 @default.
• W3152986545 cites W2163578189 @default.
• W3152986545 cites W2191219115 @default.
• W3152986545 cites W2195703978 @default.
• W3152986545 cites W2219329093 @default.
• W3152986545 cites W2263626698 @default.
• W3152986545 cites W2290365562 @default.
• W3152986545 cites W2515465032 @default.
• W3152986545 cites W2604748569 @default.
• W3152986545 cites W2782209540 @default.
• W3152986545 cites W2789167483 @default.
• W3152986545 cites W2794869516 @default.
• W3152986545 cites W2897531448 @default.
• W3152986545 cites W2903014248 @default.
• W3152986545 cites W2945538013 @default.
• W3152986545 cites W2949004837 @default.
• W3152986545 cites W2968232135 @default.
• W3152986545 cites W2974701580 @default.
• W3152986545 cites W3010763889 @default.
• W3152986545 cites W3021340031 @default.
• W3152986545 cites W3035885149 @default.
• W3152986545 cites W3042648119 @default.
• W3152986545 cites W3042894330 @default.
• W3152986545 cites W3046321541 @default.
• W3152986545 cites W3055948184 @default.
• W3152986545 cites W3080215924 @default.
• W3152986545 cites W3092410836 @default.
• W3152986545 cites W3092668967 @default.
• W3152986545 cites W3100457878 @default.
• W3152986545 cites W3107201344 @default.
• W3152986545 cites W3109310044 @default.
• W3152986545 cites W3110496306 @default.
• W3152986545 cites W3111105858 @default.
• W3152986545 cites W3111410489 @default.
• W3152986545 cites W3112454975 @default.
• W3152986545 cites W3119777496 @default.
• W3152986545 cites W3120196678 @default.
• W3152986545 cites W3125293084 @default.
• W3152986545 cites W3162414317 @default.
• W3152986545 cites W4205629872 @default.
• W3152986545 doi "https://doi.org/10.1053/j.ajkd.2021.03.008" @default.
• W3152986545 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/8238889" @default.
• W3152986545 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/33845065" @default.
• W3152986545 hasPublicationYear "2021" @default.
• W3152986545 type Work @default.
• W3152986545 sameAs 3152986545 @default.
• W3152986545 citedByCount "74" @default.

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