Becker's Clinical Quality & Infection Control

41 QUALITY IMPROVEMENT & MEASUREMENT Task force recommends dropping race from kidney function assessments By Erica Carbajal R ace should be eliminated from a formula com- monly used to evaluate kidney function, accord- ing to a Sept. 23 task force recommendation. The estimated glomerular filtration rate, or eGFR, is an equation developed more than 20 years ago to evaluate kidney health. It factors in race, age, sex and creatine — a waste product produced by the muscles and filtered out by the kidneys. Race was originally included as a factor since studies have shown that Black patients, on average, may have higher levels of creatine in their blood. However, experts have said the studies on which the inclu- sion of race are based are outdated, and based on the incorrect assumption that race is biological, rather than a social construct. Thus, many experts warned the formula overes- timated Black patients' kidney health, potentially delaying care. The new recommendation, jointly published in the American Journal of Kidney Diseases and the Journal of the American Society of Nephrology, describes an alternative equation that estimates kidney function without a race variable. "Using race as a testing factor risks kidney misdi- agnosis," said Afshin Parsa, MD, program direc- tor of the Chronic Renal Insufficiency Cohort at the National Institute of Diabetes and Digestive and Kidney Diseases. "Misdiagnosis could lead to a person receiving incorrect drug dosing, or delays in receiving dialysis or a kidney transplant. Current eGFR calculations could be exacerbating racial inequities in a disease that disproportionate- ly affects Black people." The reports also recommend using blood tests that measure cystatin C, a protein that is elevated when kidneys are not functioning well and unlike creatine, is not affected by race or ancestry. While they waited for the national recommendation, some hospitals and health systems, including Min- neapolis-based M Health Fairview and Boston-based Beth Israel Deaconess Medical Center had already stopped using race as a kidney health determinant. n Racial gap for COVID-19 vaccinations closing, data shows By Katie Adams E arlier in the pandemic, Black and Latinx Americans were less likely to get vaccinated than white Americans, but target- ed messaging campaigns and a surge in COVID-19 deaths helped close the racial vaccine hesitancy gap, The New York Times reported Oct. 13. Black, white and Latinx U.S. adults now share similar COVID-19 vac- cination rates. Seventy percent of Black adults, 71 percent of white adults and 73 percent of Latinx adults have received at least one COVID-19 vaccine dose, according to research the Kaiser Family Foundation released in late September. Some federal data signifies a larger racial gap, but the federal government's data collection practices often don't capture vaccine recipients' demographic information. Earlier vaccine hesitancy among Black and Latinx communities was fueled by misinformation, vaccine inaccessibility in their communi- ties and mistrust of the government and medical institutions. Experts told The New York Times the country's success in closing its racial vaccine hesitancy gap was due to grassroots efforts that relied on community members Black and Latinx people trust, as well as a surge in hospitalizations and death caused by the delta variant. "It's less about saying, 'This racial ethnic group is more hesitant, more unwilling to get vaccinated,' and more about saying, 'You know, this group of people in this given area or this community doesn't have the information or access they need to overcome their hesitancy,'" Nelson Dunlap, chief of staff for the Satcher Health Leadership Institute at the Morehouse School of Medicine, told The New York Times. n Overdose deaths at new high, CDC data show By Mackenzie Bean M ore than 96,000 Americans died from drug overdoses in the 12-month period ending in March, marking a new record high, according to preliminary CDC data released Oct. 13. The U.S. reported 96,779 fatal overdoses during this time period, which included the nation's first major COVID-19 surge and sweep- ing lockdowns. This figure is up 29.6 percent from the 74,679 over- dose deaths reported in the 12-month period ending in March 2020. Every state except for New Hampshire, South Dakota and New Jer- sey reported increases in overdose deaths in the 12-month period ending in March. The CDC noted that these deaths are provisional, as investigations into some drug overdose deaths may be ongoing. The agency predicts the final tally for this time period will be closer to 99,100 deaths. n

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