Health inequities and the inappropriate use of race in nephrology.

Journal Article (Journal Article;Review)

Chronic kidney disease is an important clinical condition beset with racial and ethnic disparities that are associated with social inequities. Many medical schools and health centres across the USA have raised concerns about the use of race - a socio-political construct that mediates the effect of structural racism - as a fixed, measurable biological variable in the assessment of kidney disease. We discuss the role of race and racism in medicine and outline many of the concerns that have been raised by the medical and social justice communities regarding the use of race in estimated glomerular filtration rate equations, including its relationship with structural racism and racial inequities. Although race can be used to identify populations who experience racism and subsequent differential treatment, ignoring the biological and social heterogeneity within any racial group and inferring innate individual-level attributes is methodologically flawed. Therefore, although more accurate measures for estimating kidney function are under investigation, we support the use of biomarkers for determining estimated glomerular filtration rate without adjustments for race. Clinicians have a duty to recognize and elucidate the nuances of racism and its effects on health and disease. Otherwise, we risk perpetuating historical racist concepts in medicine that exacerbate health inequities and impact marginalized patient populations.

Full Text

Duke Authors

Cited Authors

  • Eneanya, ND; Boulware, LE; Tsai, J; Bruce, MA; Ford, CL; Harris, C; Morales, LS; Ryan, MJ; Reese, PP; Thorpe, RJ; Morse, M; Walker, V; Arogundade, FA; Lopes, AA; Norris, KC

Published Date

  • February 2022

Published In

Volume / Issue

  • 18 / 2

Start / End Page

  • 84 - 94

PubMed ID

  • 34750551

Pubmed Central ID

  • PMC8574929

Electronic International Standard Serial Number (EISSN)

  • 1759-507X

Digital Object Identifier (DOI)

  • 10.1038/s41581-021-00501-8


  • eng

Conference Location

  • England