LOUISVILLE, Ky. (WDRB) -- A new way to measure kidney health is expected to save lives, particularly for Black Americans.

Chronic kidney disease is more common in Black Americans, and can be attributed to an old method of detection, according to Dr. La'Tonzia Adams.

Charles Clinton Adams served in the Vietnam War for the U.S. military and was a life-long firefighter in Gary, Indiana. He was a beloved member in the community and known for his dedication to his job.

"He was a great man," said Dr. La'Tonzia Adams, his daughter. "He worked a lot, he had strong work ethic. Just very caring, very giving. He loved his family."

But Adams' loving father began to struggle when she was a teenager. She found her father on the floor.

"He suffered a stroke. He had high blood pressure and diabetes," La'Tonzia said.

The firefighter recuperated from the stroke and went to therapy, but he wasn't the same.

"He started acting different, his behavior was a bit odd," La'Tonzia said. "He was tired. He had hiccups, that was a sign he was becoming toxic because his kidneys weren't functioning appropriately, but we didn't know that."

While in Chicago with his wife, Charles was taken to the emergency room in need of dialysis. 

La'Tonzia offered to give her kidney to her father, but he was too sick for a transplant.

"It was very challenging to see your father who was this strong, strapping man slowly deteriorate," La'Tonzia said. "You couldn't do anything about it."

Charles died at 55 years old in 2001 after an infection.

Inspired by her father, La'Tonzia became a doctor and now lives in Portland, Oregon. She hopes others with kidney issues won't go through what her father did by detecting symptoms earlier.

According to the Center for Disease Control and Prevention, 15% of US adults are estimated to have chronic kidney disease. The CDC reports 9 in 10 adults with chronic kidney disease do not know they have the disease, while two in five adults with a severe form of the disease don't know they have it. 

Estimated glomerular filtration rate (eGFR) is a test that measure a person's level of kidney function. It determines a patient's stage of kidney disease. But the test on a scale of 0-100 was weighted differently for Black Americans.

"It gave African Americans an elevated eGFR, meaning it made them appear that their kidney function was better than what it really was," La'Tonzia said. "The belief that African Americans had higher level of creatinine in their blood that was based off misconceived notion that Blacks had more muscle mass."

In September 2021, the American Kidney Foundation came out with new guidelines for the eGFR. The new guidelines removed the old practices of weighting Black Americans results due to creatinine levels. 

Dr. Emily Volk, who has spent the past two years at UofL Health, has worked on spreading information on the updated guidelines. She serves as the president of the College of American Pathologists.

Volk credited colleagues who specialized in clinical chemistry as scientists responsible for the change in the testing calculations.

She hopes all labs across the country are using the update model to measure kidney function by next year.

"As we understand it, around 30% of labs across the country still have the opportunity to make the change," Volk said. "When you make a change in a lab test, especially in a health system, it touches the electronic medical record. So these changes have to be thought through."

Volk expects the more accurate test results will lead to fewer patients requiring dialysis and transplants in the future.

"When we were using a race-based calculation to measure kidney function, we were actually doing a disservice to the African American population, to Black patients by not catching early enough kidney disease," Volk said. "Now that we've taken out this race-based adjustment, we are going to identify more patients as having kidney issues earlier in their treatment."

La'Tonzia said the new equation is more reflective of a patient's true clinical state. 

"More Black Americans being tested have a better chance of surviving," La'Tonzia said. "Those at risk have hypertension and diabetes, most common conditions for chronic kidney disease. It's important their kidney functions can be assessed accurately and appropriately."

 She has shared the updated model with colleagues and has devoted her time advocating for kidney health.

"It means that we're getting closer to a point where disparities are being recognized," La'Tonzia said. "Now we're actually taking forward movements on a national and larger scale to rectify these issues. This is huge in that it's really putting out there that race is not a biological but social construct."

"We understand that there is baked in racial bias in all aspects of society. And so in healthcare, we're looking more critically at where we can undo some of the sins of the past. So, why did it take so long? We weren't looking hard enough, but now we are," Volk said.

kIDNEY DISEASE TEST CHANGE

Dr. Emily Volk with UofL Health speaks with WDRB News on March 20, 2023.

She said more than half the labs, across the country, have now implemented this change. The goal is to have it added into all labs and hospitals across the country soon.

Both Volk and La'Tonzia suggest patients ask if their lab is using the new, non-race-based equation before being tested.

People develop chronic kidney disease when their kidneys become damaged and over time don't clean the blood as well as healthy kidneys. Kidneys that aren't functioning properly don't process toxic waste and extra fluid that accumulates in the body, which can lead to high blood pressure, heart disease, stroke and early death.

"There are certain interventions you can take on early on before it even gets to a point where you're even considering a transplant and that's what the issue was in the past is that you had patients who their GFR appeared normal, not at a critical level, but in actuality, clinically they were presenting very ill," La'Tonzia said.

Steps to keep kidneys health include managing blood sugar and blood pressure, along with keeping a healthy body weight through a balanced diet and physical activity.

To learn more about kidney health, click here to visit the National Kidney Foundation.

The month of March is National Kidney Awareness Month.

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