Curbside Consults Podcast

By Clement Lee, MD, MSc

Published January 12, 2022

In this episode of Curbside Consults, we examine the latest guidelines on reassessing the inclusion of race in eGFR equations from the National Kidney Foundation (NKF) and American Society of Nephrology (ASN). We are joined by one of the guideline authors — Nwamaka Eneanya, Director of Health Equity, Anti-Racism and Community Engagement at Penn Medicine.

00:05 – Intro
00:40 – Background on eGFR equations
04:12 – Explaining race-based medicine
05:48 – Arguments for including race adjustment
07:42 – Overview of guideline development
09:30 – Different eGFR equations
10:25 – Bias, precision, and accuracy
11:20 – New 2021 eGFR equation without race
12:14 – The three guideline recommendations
14:25 – Cystatin C
15:38 – Two patient cases
18:05 – Concluding remarks and medical student advocacy

Articles discussed in this episode:

1. Delgado C et al. A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease. JASN 2021.
2. Levey AS et al. A More Accurate Method to Estimate Glomerular Filtration Rate from Serum Creatinine: A New Prediction Equation. Ann Intern Med 1999.
3. Inker LA et al. New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race. N Engl J Med 2021.

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

Dr. Nwamaka Eneanya is Director of Health Equity, Anti-Racism and Community Engagement at Penn Medicine.
Clement Lee, MD, MSc, is a 2021–2022 NEJM Editorial Fellow.