期刊
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION
卷 30, 期 6, 页码 525-530出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MNH.0000000000000739
关键词
creatinine adjustment; estimating GFR; race coefficient
The ongoing debate about the race coefficient in the modification of diet for renal diseases and chronic kidney disease is centered on whether it is necessary for black individuals. Recent studies have shown that the race coefficient is inaccurate for European and African black populations, suggesting that it might be specific to black Americans. Criticism has arisen over the correction at the glomerular filtration rate level, with calls for dedicated studies in both Europe and the USA.
Purpose of review There is currently a heated debate ongoing whether or not to use the race coefficient for black people in the Modification of Diet in Renal Diseases and Chronic Kidney Disease Epidemiology-equation. The use of the race coefficient is thought by several American authors as a source of discrimination. Recent findings It has recently been shown that the race coefficient is inaccurate in European and African black people. Therefore, it seems that the race correction is more a correction for black Americans, rather than for black in general. This 'correction' at the glomerular filtration rate (GFR)-level has been criticized, as it is misleading, and should be abandoned, as it has not been shown that GFR is different between black and white people. However, as differences in creatinine generation between black and white people might exist, a correction or adjustment, different for black and white people, at the creatinine level might be required, very similar to the different scaling of creatinine for males and females. The current debate on the race coefficient is particularly difficult because of the absence of good scientific data in black subjects and there lies the real discrimination in our opinion. We therefore call for future dedicated studies, both in Europe and USA.
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