Using race to estimate glomerular filtration and its impact in kidney transplantation

Sarat Kuppachi, Silas P. Norman, Krista L. Lentine, David A. Axelrod

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Since direct measurement of glomerular filtration rate (GFR) is time-consuming and more expensive, estimated GFR (eGFR) based on measured laboratory values is widely used to determine kidney function. Commonly used formulae to calculate eGFR are dependent on variables, which include filtration markers like serum creatinine and patient characteristics including race. Medical algorithms which utilize race are increasingly being scrutinized, as race is recognized to be a social construct rather than a biologic one. eGFR calculations have important implications for kidney transplantation, both in the listing of candidates as well as in the evaluation of potential kidney donors. This review considers the specific implications of race-based eGFR calculations on recipient evaluation and on decisions related to living kidney donation. We suggest a potential policy solution to ensure that racial and ethnic minority patients are not disadvantaged by eGFR as a result of current calculation methods.

Original languageEnglish (US)
Article numbere14136
JournalClinical Transplantation
Issue number1
StatePublished - Jan 2021


  • Organ Procurement and Transplantation Network
  • disparities
  • donors and donation
  • ethnicity
  • glomerular filtration rate
  • living
  • race

ASJC Scopus subject areas

  • Transplantation


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