Medica is calling on its network of providers to adopt a new clinical guideline to diagnose and assess kidney disease that will lead to more equitable renal care and improved outcomes among Black Americans. The change is expected to reduce delays in referrals for specialist care and kidney transplants.
Medica is asking doctors to stop using the most common method to diagnose and assess the severity of kidney disease, which is estimated glomerular filtration rate (eGFR). Most providers calculate eGFR by assuming Black people generally have higher baseline levels of serum creatinine, and therefore adjust their scores upward. This method can overestimate kidney function in people with African ancestry, and lead to worse outcomes.
“Using race as a factor when estimating kidney health is imprecise and disproportionately puts Black Americans at risk for severe health complications that could otherwise be treated,” said Medica Medical Director Charlotte G. Hovet, M.D., Sr. Medical Director of Quality, Care and Utilization Management.
“Our mission is to earn the trust of those we serve, and with that comes our commitment to being an active ally and advocate for changes that help make the lives of all people healthier and happier,” Hovet said.
Black people are about three times more likely to develop kidney failure than white people, according to the National Kidney Foundation. Black people are also less likely to receive a transplant evaluation, have less access to the waitlist, spend longer time on the waitlist, are less likely to survive on the waitlist, and have lower rates of transplant success.
Medica’s Medical Policy Committee, comprised of credentialed Medica-network physicians in a variety of disciplines, voted to adopt a new guideline that recommends providers use either a direct measure of GFR or another method of estimating GFR using serum cystatin C, which does not involve consideration of the patient’s race.
Hovet said the new guidelines align with leading advocates for the advancement of equity in kidney care.