Current race-based eGFR calculators assign a higher eGFR value to Black patients, which could affect the care of kidney transplant candidates and potential living donors.

We conducted a survey of staff at adult kidney transplant centers in the United States (December 17, 2020 to February 28, 2021) to assess opinions on use of race-based eGFR equations for waitlisting and living donor candidate evaluation, availability of serum cystatin C testing and measured GFR, and related practices.

Respondents represented 57% (124 of 218) of adult kidney transplant programs, and the responding centers conducted 70% of recent kidney transplant volume. Most (93%) programs use serum creatinine–based eGFR for listing candidates. However, only 6% of respondents felt that current race-based eGFR calculators are appropriate, with desire for change grounded in concerns for promotion of health care disparities by current equations and inaccuracies in reporting of race. Most respondents (70%) believed that elimination of race would allow more preemptive waitlisting for Black patients, but a majority (79%) also raised concerns that such an approach could incur harms. More than one third of the responding programs lacked or were unsure of availability of testing for cystatin C or measured GFR. At this time, 40% of represented centers did not plan to remove race from eGFR calculators, 46% were planning to remove, and 15% had already done so. There was substantial variability in eGFR reporting and listing of multiracial patients with some Black ancestry. There was no difference in GFR acceptance thresholds for Black versus non-Black living donors.

This national survey highlights a broad consensus that extant approaches to GFR estimation are unsatisfactory, but it also identified a range of current opinions.

目前基于种族的 eGFR 计算器为黑人患者分配了更高的 eGFR 值，这可能会影响肾移植候选者和潜在活体捐赠者的护理。

我们对美国成人肾移植中心的工作人员进行了一项调查（2020 年 12 月 17 日至 2021 年 2 月 28 日），以评估对使用基于种族的 eGFR 方程进行候补和活体供体候选人评估、血清胱抑素 C 可用性的意见测试和测量 GFR，以及相关实践。

受访者占成人肾移植计划的 57%（218 人中的 124 人），响应中心进行了近期肾移植量的 70%。大多数 (93%) 计划使用基于血清肌酐的 eGFR 来列出候选人。然而，只有 6% 的受访者认为目前基于种族的 eGFR 计算器是合适的，他们希望改变是基于对当前方程式和种族报告不准确促进医疗保健差异的担忧。大多数受访者 (70%) 认为，消除种族将允许黑人患者更先发制人地等待，但大多数 (79%) 也担心这种方法可能会造成伤害。超过三分之一的响应项目缺乏或不确定检测胱抑素 C 或测量 GFR 的可用性。此时，40% 的代表中心不打算从 eGFR 计算器中删除种族，46% 计划删除，15% 已经这样做了。eGFR 报告和具有一些黑人血统的多种族患者列表存在很大差异。黑人与非黑人活体捐献者的 GFR 接受阈值没有差异。

这项全国调查强调了一种广泛的共识，即现有的 GFR 估计方法并不令人满意，但它也确定了一系列当前的观点。