eGFR, or estimated glomerular filtration rate, is a calculated test that measures your kidney function. This calculation comes from a creatinine blood test. American Kidney Fund classifies kidney disease in 5 stages based on eGFR calculations.
The stages are as follows:
Stage 1: eGFR ≥ 90; kidneys work as well as normal
Stage 2: eGFR 60-89; mild kidney damage
Stage 3: eGFR 45-59; mild to moderate kidney damage
Stage 4: eGFR 30-44; moderate to severe kidney damage
Stage 5: eGFR < 15; kidney failure
This calculation can be used by healthcare providers to determine your treatment plan. Some courses of action that can be taken based on your eGFR are deciding when to refer to a kidney specialist, when to begin dialysis, or see when you can be placed on a transplant list.
The current test for eGFR takes into consideration a patients age, sex, and race. Race was originally taken into account when the eGFR calculation was created because individuals who self-identified as African American had, on average, higher levels of Creatinine in their blood. This was originally thought to be due to higher muscle mass, diet, and how kidneys eliminate creatinine.
It is now known that race is a social construct and using race as a factor for eGFR calculations does not account for diversity within populations of people of color. Multi-racial individuals also may not choose to be placed into single race categories.
In 2020, the National Kidney Foundation and the American Society of Nephrology began review of the eGFR calculations. On September 23, 2021 this Task Force announced a race-free eGFR calculation and the National Kidney Foundation has been working to implement this calculation in laboratories across the nation.
People of color have historically been disproportionately impacted in a negative way in healthcare, and the NKF is working to address inequalities in kidney health. Implementing a race-free eGFR is a step in the right direction to ensure folks of all races receive equal healthcare.