![]() ![]() The three small studies referenced, however, relied on convenience samples, did not support the use of race as an informative substitute for muscle mass, and provided no control for social factors, ,, ,, ,, , ]. īlack Americans could differ from the referent population in countless social, material and lifestyle dimensions, but the MDRD authors provided only one post hoc justification for inclusion of race in the equation, suggesting that race proxies average differences in muscle mass between Black and White subjects. A subsequent abstract narrowed these variables and proposed a “race” coefficient of 1.21. “Black ethnicity” was among six variables that achieved a p-value of less than 0.001. Without specifying a functional definition or hypothesis, authors of the 1999 study included “Black ethnicity” among the initial predictor variables in stepwise regression modeling effects on GFR. Though the MDRD study did demonstrate that as a group, self-reported Black patients had a higher measured GFR when compared to White patients with the same serum creatinine concentrations, it is important to recognize that the process by which Black race was included in the MDRD is specious. These race-specific adjustments have spurred growing controversy in recent years. These equations include race adjustments that multiply eGFR by 1.21 or 1.16 respectively, if the patient is identified as “Black.”. Two equations for eGFR predominate in North American healthcare systems: the 1999 Modification of Diet in Renal Disease (MDRD) equation, and the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Given its clinical utility, quantitative eGFR thresholds inform referral to specialty care, medication dosing, and evaluation for the kidney transplant waitlist. Estimated glomerular filtration rate (eGFR) emerged as a convenient alternative to 24-hour urine collection and remains the predominant method of assessing kidney function and progression of CKD worldwide. Chronic kidney disease (CKD) involves alteration of the kidney resulting in damage or decreased function for at least three months, regardless of the cause. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |