Why is Race So Central To Medical Practice?

“It works” is not a good enough reason.

I’d like you to think about the last time you gave a formal patient presentation. You know, for a talk, or during rounds or whatever. You probably said something like:

This is a 38 year old, black man who presented with a chief complaint of fever…

-Typical case presentation

And it went on from there. Age, race, gender. I know that style was engrained in my head. But… why race?

I got to thinking about this when I read this research letter, appearing in JAMA, talking about our eGFR estimating equation.

GFR, or glomerular filtration rate, is an important metric for kidney function, but its really hard to measure directly — it requires a timed infusion of a drug like iothalomate and pretty advanced analytics — you’re not getting this at your local lab.

So, brilliant scientists, some of whom are my friends and colleagues, developed equations that can take just a few easily-measured variables and predict GFR. The best such equation, known as CKD-Epi, looks like this: