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Health inequities and the inappropriate use of race in nephrology

Chronic kidney disease is an important clinical condition beset with racial and ethnic disparities that are associated with social inequities. Many medical schools and health centres across the USA have raised concerns about the use of race — a socio-political construct that mediates the effect of s...

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Autores principales: Eneanya, Nwamaka D., Boulware, L. Ebony, Tsai, Jennifer, Bruce, Marino A., Ford, Chandra L., Harris, Christina, Morales, Leo S., Ryan, Michael J., Reese, Peter P., Thorpe, Roland J., Morse, Michelle, Walker, Valencia, Arogundade, Fatiu A., Lopes, Antonio A., Norris, Keith C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8574929/
https://www.ncbi.nlm.nih.gov/pubmed/34750551
http://dx.doi.org/10.1038/s41581-021-00501-8
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author Eneanya, Nwamaka D.
Boulware, L. Ebony
Tsai, Jennifer
Bruce, Marino A.
Ford, Chandra L.
Harris, Christina
Morales, Leo S.
Ryan, Michael J.
Reese, Peter P.
Thorpe, Roland J.
Morse, Michelle
Walker, Valencia
Arogundade, Fatiu A.
Lopes, Antonio A.
Norris, Keith C.
author_facet Eneanya, Nwamaka D.
Boulware, L. Ebony
Tsai, Jennifer
Bruce, Marino A.
Ford, Chandra L.
Harris, Christina
Morales, Leo S.
Ryan, Michael J.
Reese, Peter P.
Thorpe, Roland J.
Morse, Michelle
Walker, Valencia
Arogundade, Fatiu A.
Lopes, Antonio A.
Norris, Keith C.
author_sort Eneanya, Nwamaka D.
collection PubMed
description Chronic kidney disease is an important clinical condition beset with racial and ethnic disparities that are associated with social inequities. Many medical schools and health centres across the USA have raised concerns about the use of race — a socio-political construct that mediates the effect of structural racism — as a fixed, measurable biological variable in the assessment of kidney disease. We discuss the role of race and racism in medicine and outline many of the concerns that have been raised by the medical and social justice communities regarding the use of race in estimated glomerular filtration rate equations, including its relationship with structural racism and racial inequities. Although race can be used to identify populations who experience racism and subsequent differential treatment, ignoring the biological and social heterogeneity within any racial group and inferring innate individual-level attributes is methodologically flawed. Therefore, although more accurate measures for estimating kidney function are under investigation, we support the use of biomarkers for determining estimated glomerular filtration rate without adjustments for race. Clinicians have a duty to recognize and elucidate the nuances of racism and its effects on health and disease. Otherwise, we risk perpetuating historical racist concepts in medicine that exacerbate health inequities and impact marginalized patient populations.
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spelling pubmed-85749292021-11-09 Health inequities and the inappropriate use of race in nephrology Eneanya, Nwamaka D. Boulware, L. Ebony Tsai, Jennifer Bruce, Marino A. Ford, Chandra L. Harris, Christina Morales, Leo S. Ryan, Michael J. Reese, Peter P. Thorpe, Roland J. Morse, Michelle Walker, Valencia Arogundade, Fatiu A. Lopes, Antonio A. Norris, Keith C. Nat Rev Nephrol Review Article Chronic kidney disease is an important clinical condition beset with racial and ethnic disparities that are associated with social inequities. Many medical schools and health centres across the USA have raised concerns about the use of race — a socio-political construct that mediates the effect of structural racism — as a fixed, measurable biological variable in the assessment of kidney disease. We discuss the role of race and racism in medicine and outline many of the concerns that have been raised by the medical and social justice communities regarding the use of race in estimated glomerular filtration rate equations, including its relationship with structural racism and racial inequities. Although race can be used to identify populations who experience racism and subsequent differential treatment, ignoring the biological and social heterogeneity within any racial group and inferring innate individual-level attributes is methodologically flawed. Therefore, although more accurate measures for estimating kidney function are under investigation, we support the use of biomarkers for determining estimated glomerular filtration rate without adjustments for race. Clinicians have a duty to recognize and elucidate the nuances of racism and its effects on health and disease. Otherwise, we risk perpetuating historical racist concepts in medicine that exacerbate health inequities and impact marginalized patient populations. Nature Publishing Group UK 2021-11-08 2022 /pmc/articles/PMC8574929/ /pubmed/34750551 http://dx.doi.org/10.1038/s41581-021-00501-8 Text en © Springer Nature Limited 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Review Article
Eneanya, Nwamaka D.
Boulware, L. Ebony
Tsai, Jennifer
Bruce, Marino A.
Ford, Chandra L.
Harris, Christina
Morales, Leo S.
Ryan, Michael J.
Reese, Peter P.
Thorpe, Roland J.
Morse, Michelle
Walker, Valencia
Arogundade, Fatiu A.
Lopes, Antonio A.
Norris, Keith C.
Health inequities and the inappropriate use of race in nephrology
title Health inequities and the inappropriate use of race in nephrology
title_full Health inequities and the inappropriate use of race in nephrology
title_fullStr Health inequities and the inappropriate use of race in nephrology
title_full_unstemmed Health inequities and the inappropriate use of race in nephrology
title_short Health inequities and the inappropriate use of race in nephrology
title_sort health inequities and the inappropriate use of race in nephrology
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8574929/
https://www.ncbi.nlm.nih.gov/pubmed/34750551
http://dx.doi.org/10.1038/s41581-021-00501-8
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