Honors Theses and Capstones

Date of Award

Spring 2021

Project Type

Senior Honors Thesis

College or School

COLSA

Department

Molecular, Cellular, and Biomedical Sciences

Program or Major

Biomedical Sciences: Medical Laboratory Sciences

Degree Name

Bachelor of Science

First Advisor

Juan Rojo

Abstract

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information about healthcare professionals’ reception of the racial multiplier’s use. Use of the multiplier across the globe was found to be inconsistent. The survey found that there are many hospital systems across the US that report the racial multiplier and varying opinions among healthcare providers about its use. Applying the racial multiplier increases the eGFR of a patient by 16-21%, which may categorize a patient as being at a less severe stage of CKD than appropriate. The lack of consistency in the application of the racial multiplier, coupled with the understanding that race is not a biological characteristic, contraindicates its inclusion in a diagnostic algorithm. Inappropriate use of the racial multiplier causes delay to necessary treatments for affected patients. The inability to sort people into discrete racial categories on biological lines and lack of studies definitively supporting the racial multiplier calls for reevaluation of its use.

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