Race-Free Creatinine Equation May Cut Disparity in Kidney Wait Time

TUESDAY, Sept. 27, 2022 (HealthDay News) — Use of the creatinine race-free 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to determine eligibility for the kidney transplant wait list may reduce racial differences in preemptive wait time accrual, according to a study published online Sept. 21 in the Clinical Journal of the American Society of Nephrology.

Elaine Ku, M.D., Ph.D., from the University of California in San Francisco, and colleagues conducted a retrospective cohort study involving Black or White Chronic Renal Insufficiency Cohort (CRIC) patients who were theoretically eligible for wait-list registration. The association between race and time to kidney failure from the qualifying visit when the estimated glomerular filtration rate fell to ≤20 mL/min per 1.73 m² by creatinine or creatinine-cystatin C 2021 CKD-EPI equations was examined.

The researchers found that 472 CRIC participants were eligible for wait-list registration by the creatinine equation, and the potential preemptive wait time was 23 and 22 months for Black and White participants, respectively (time ratio, 1.05; 95 percent confidence interval, 0.81 to 1.35). A total of 441 CRIC participants were eligible by the creatinine-cystatin C equation, and the potential wait time was shorter for Black versus White participants (21 versus 26 months). The ratio of the time ratio of the models was significantly different using the creatinine versus creatinine-cystatin C equation when using bootstrapping (ratio of the time ratios, 1.31; 95 percent confidence interval, 1.06 to 1.62).

“Using the race-free creatinine equation to determine waitlist eligibility is the strategy that may reduce racial differences in access to preemptive wait-time accrual the most,” Ku said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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