When the Numbers Lied: How Race-Based Testing Delayed Kidney Care

The test that measured us differently

African Americans are three to four times more likely to develop kidney failure compared to white Americans. But for years, the test used to measure kidney function made that disparity even worse.

The eGFR test measures how well your kidneys filter waste from your blood. Until recently, it included a race-based adjustment that automatically gave Black patients higher scores—making their kidneys appear healthier than they actually were. That multiplier wasn't based on biology. It was based on flawed assumptions about race and muscle mass.

The result? Black patients with failing kidneys were diagnosed later, referred to specialists later, and placed on transplant waiting lists later—if they qualified at all.

14,000 patients reclaimed their time

In 2021, the National Kidney Foundation and American Society of Nephrology recommended removing race from the eGFR calculation. By January 2023, a new policy allowed Black transplant candidates to receive credit for lost waiting time.

Over 14,000 Black kidney transplant candidates have had their wait times adjusted—by an average of two years. More than 2,800 have since received transplants. These aren't just statistics—they're mothers, fathers, and community members who deserved fair treatment from the start.

Why this matters for our community

Black Americans represent 13% of the U.S. population but account for over 35% of people on dialysis. The disparities are driven by higher rates of diabetes, hypertension, limited access to preventive care, and structural inequities that have historically devalued Black lives.

Chronic kidney disease progresses silently. For Black patients, that silent progression was made more dangerous by a testing system that underestimated their condition. When you're not diagnosed until late-stage kidney disease, your options narrow and your life expectancy drops.

What you can do right now

Know your numbers. Ask your doctor for your eGFR and creatinine levels, and confirm they're using the updated race-neutral calculation.

Talk to your family. Share what you know about kidney disease risk and testing. In Black families, we don't always discuss medical history—but silence can be deadly.

Advocate for yourself. If you're on the transplant list, confirm your waiting time is accurate. If you feel dismissed, seek a second opinion. You have the right to fair treatment.

Manage risk factors. If you have diabetes or high blood pressure, work aggressively with your care team to control them—both are leading causes of kidney disease.

The fight continues

The removal of race from eGFR calculations is a victory—but it's not the end. This is part of a larger movement to dismantle medical racism in all its forms. Black patients have been underserved, under-believed, and under-protected for too long.

Your kidneys deserve accurate testing. Your life deserves equitable care. And your community deserves a healthcare system that sees you, hears you, and treats you fairly—every single time.