African American Academic Librarians an Evidence Map Case Study Using Rapid Review Methodology

Limited Evidence for Use of a Black Race Modifier in eGFR Calculations: A Systematic Review

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Mark A Marzinke,

Departments of Pathology and Medicine, Johns Hopkins University Schoolhouse of Medicine

, Baltimore, Doctor

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Dina N Greene,

Department of Laboratory Medicine and Pathology, University of Washington

, Seattle, WA

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Patrick One thousand Bossuyt,

Deptartment of Epidemiology and Information Scientific discipline, Amsterdam University Medical Centers, Academy of Amsterdam

, Amsterdam,

Netherlands

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Allison B Chambliss,

Section of Pathology, University of Southern California

, Los Angeles, CA

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Lauren R Cirrincione,

Section of Chemist's, University of Washington

, Seattle, WA

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Christopher R McCudden,

Section of Pathology and Laboratory Medicine, The Ottawa Hospital, University of Ottawa, Eastern Ontario Regional Laboratory Clan

, Ottawa, Ontario,

Canada

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Stacy E F Melanson,

Section of Pathology, Brigham and Women'due south Hospital, Harvard Medical School

, Boston, MA

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Jaime H Noguez,

Department of Pathology, Academy Hospitals Cleveland Medical Eye, Case Western Reserve Academy

, Cleveland, OH

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Khushbu Patel,

Department of Pathology and Laboratory Medicine, University of Pennsylvania

, Philadelphia, PA

Callen-Lorde Community Health Center

, New York, NY

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Asa E Radix,

Test Evaluation Enquiry Group, Institute of Applied Health Research, University of Birmingham and NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham

, Birmingham,

Britain

Department of Medicine, New York University Schoolhouse of Medicine

, New York, NY

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... Evidence more than

Received:

14 September 2021

Accustomed:

13 Dec 2021

Published:

20 December 2021

Abstract

Background

Commonly used estimated glomerular filtration rate (eGFR) equations include a Blackness race modifier (BRM) that was incorporated during equation derivation. Race is a social construct, and a poorly characterized variable that is applied inconsistently in clinical settings. The BRM results in higher eGFR for any creatinine concentration, implying fundamental differences in creatinine product or excretion in Black individuals compared to other populations. Equations without inclusion of the BRM have the potential to find kidney illness earlier in patients at the greatest risk of chronic kidney illness (CKD), but as well has the potential to over-diagnose CKD or impact downstream clinical interventions. The purpose of this study was to use an evidence-based approach to systematically evaluate the literature relevant to the functioning of the eGFR equations with and without the BRM and to examine the clinical impact of the use or removal.

Content

PubMed and Embase databases were searched for studies comparing measured GFR to eGFR in racially diverse developed populations using the Modification of Diet in Renal Affliction or the 2009-Chronic Kidney Illness Epidemiology Collaboration-creatinine equations based on standardized creatinine measurements. Additionally, we searched for studies comparison clinical employ of eGFR calculated with and without the BRM. Here, 8632 unique publications were identified; an additional 3 studies were added post hoc. In total, 96 studies were subjected to farther analysis and 44 studies were used to make a concluding assessment.

Summary

In that location is limited published evidence to support the employ of a BRM in eGFR equations.

© American Association for Clinical Chemistry 2022. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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Source: https://academic.oup.com/clinchem/article/68/4/521/6470563

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