Removing race from CKD-EPI will calculate lower eGFR for Black patients and exclude more from receiving chemo<\/p>\n<\/h3>\n
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WEDNESDAY, Sept. 1, 2021 (HealthDay News) — Removing race from the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation will calculate a lower estimated glomerular filtration rate (eGFR) for Black patients and exclude more from receiving chemotherapy, according to a study published online Aug. 13 in The Lancet Oncology<\/em>.<\/p>\n Morgan A. Casal, Pharm.D., from the School of Pharmacy at the University of Pittsburgh, and colleagues conducted a retrospective analysis of patients enrolled in phase 1 studies sponsored by the Cancer Therapy Evaluation Program between January 1995 and October 2010. The CKD-EPI equation and a version of the CKD-EPI without the race term (CKD-EPIwithout race<\/sub>) were used to calculate eGFR based on creatinine (eGFRcr<\/sub>). The Cockcroft-Gault equation was used to calculate estimated creatinine clearance (eClcr<\/sub>). For 10 anticancer drugs, dosing simulations based on each assessment of kidney function were conducted.<\/p>\n Demographic and laboratory values were included from 340 Black patients. The researchers found that the median eGFRcr<\/sub> was 103 mL\/min and 89 mL\/min calculated by CKD-EPI and CKD-EPIwithout race<\/sub>, respectively, and the eClcr<\/sub> was 90 mL\/min by Cockcroft-Gault. Compared with the CKD-EPI, the number of patients ineligible for therapy or recommended to receive any renal dose adjustment was increased when CKD-EPIwithout race<\/sub> was used, but was at a similar rate when Cockcroft-Gault was used. Using CKD-EPIwithout race<\/sub> versus CKD-EPI, up to 18 percent of patients had discordant recommendations.<\/p>\n “Exclusion of the race term from the CKD-EPI equation could paradoxically worsen care for Black patients with cancer,” the authors write.<\/p>\n Several authors disclosed financial ties to the pharmaceutical industry.<\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n Editorial (subscription or payment may be required)<\/a><\/p>\n <\/i><\/p>\n