Can an Equation to Help Determine Kidney Health Be Racist?

^{"creatinine" by Lori Greig is licensed under CC 2.0}

On the morning of June 19, 2020—Juneteenth, now a federal holiday — students in the Internal Medicine Residency Program at the University of California, Davis gathered for weekly rounds. Rachael Lucatorto, the associate program director, opened the session by playing a recording of the Emancipation Proclamation. She then jumpstarted a discussion about racism in medicine.

For Bisrat Woldemichael, then a fourth year medical student at UC Davis and now a resident at Emory University, it was a chance to speak about racism in kidney care, or nephrology. Black Americans experience kidney failure nearly four times as often as White Americans. And yet they are less likely to receive timely referrals to a specialist.

One big problem, Woldemichael remembers pointing out that June morning, was that a common tool for measuring kidney health factored in race. “Racism is very obviously present in a lot of ‘objective’ data in medicine,” she says. Many equations and guidelines adjust for race, and while it is sometimes a convenient proxy, critics say...