DEI Priorities Create Havoc in Kidney Transplant System
In 2020, a quasi-governmental nonprofit that runs American transplant centers created a new formula to assess kidney function, ignoring scientifically determined body composition differences. Now nonblacks are being moved to the back of the transplant line.
This week, Professor Jacobson discussed Diversity-Equity-Inclusion (DEI) crisis within the nation’s medical schools with Sandy Rios of American Family Radio, for her Sandy Rios 24/7 podcast.
And what we found is that CRT/DEI, whatever you want to call it, I call it the racialization of education, is deeply permeated throughout medical schools. And in some ways, it’s worse in medical schools than in higher ed in general. So we found out about it because we were interested more generally in the education topic, and then we started to get complaints and tips from people about medical schools.
The push for race-based preferences is impacting other areas of medicine as well. DEI readjustments are now being made for calculations based on the medical records associated with patients who have kidney issues and may require organ transplants.
The likely consequence of the new decision matrix that is intended to speed up transplants for black patients is the death of nonblacks who more urgently need the organs.
Kidney function is assessed by determining how efficiently the organs are removing creatinine, which is a chemical waste product of creatine. Creatine is a chemical made by the body and is used to supply energy mainly to muscles. Creatinine is removed from the body entirely by the kidneys.
When determining the advancement of kidney disease, doctors use an estimated glomerular filtration rate (eGFR) to determine how fast the kidneys are removing excess creatinine from the body, and the kidney transplant list uses the eGFR to determine the order in which patients would receive kidneys.
Rationally, the eGFR included an ethnicity-based calculation to account for the different normal levels of creatinine, so that really sick people would get transplants first, and people who were not sick would not get a transplant that they did not need.
Why was ethnicity a consideration in this calculation?
Because based on actual science, body composition differences (especially in muscle mass) mean that black people have higher serum creatinine concentrations than white people. In fact, there can be up to a six-fold difference. The following comes from a study published in the Clinical Journal of the American Society of Nephrology:
Adjusted mean serum creatinine concentrations were significantly higher in black versus nonblack patients (11.7 versus 10.0 mg/dl; P < 0.0001). Black patients were roughly four-fold more likely to have a serum creatinine concentration >10 mg/dl and six-fold more likely to have a serum creatinine concentration >15 mg/dl. Higher serum creatinine concentrations were associated with a lower relative risk for death (0.93; 95% confidence interval 0.88 to 0.98 per mg/dl); the association was slightly more pronounced among nonblack patients.
United Network for Organ Sharing (UNOS), a quasi-governmental nonprofit that runs American transplant centers, enacted a significant policy change. In 2020, a task force with the group decided (in the name of equity) to ignore the science and erase the ethnic adjustment from the formula that was originally being used.
Logic and reason would lead one to conclude that transplant organs would subsequently be heading to black patients with moderate kidney disease who might otherwise be able to wait. The nonblacks with severe kidney disease would be out of luck.
Paul T. Williams, a retired biostatistician with 25 years of experience as an extramural investigator for the National Institutes of Health, offered a chilling assessment of the likely consequences of this formula change.
The new formula sacrifices accuracy in the name of equity. A team of researchers, publishing in the Journal of the American Society of Nephrology, estimated that the new formula will deem more than 10 million nonblack patients to have either less severe chronic kidney disease or no disease at all—while deeming more than 1 million black patients to have more severe disease or to have disease for the first time. Because the new formula doesn’t include the necessary racial adjustments, however, these reclassifications misrepresent reality.
The human costs of this change will be severe. For every black patient who gains quicker access to treatment, ten nonblack patients risk losing such access. As those patients spend more time waiting for care or a new kidney, their conditions may worsen and bring some to the point of kidney failure, which, untreated, inevitably leads to death.
You would not give a person with type “O” blood a donation from someone with “AB” blood in the name of “equity.” That would be lethal to the patient. Individuals have a wide range of differing body compositions, chemistries, and other factors that means medical decisions should be based on strictly on actual medical science.
Choices for patient care should not be based strictly on the racial box checked.
This formula change is toxic, and likely to kill patients needlessly. Hopefully, there will be a regulatory or legal remedy to this deadly and dangerous nonsense.
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Comments
So medicine is racist if it doesn’t take into account differences between different ethnicities, and it is racist if it does take into account differences between ethnicities? It’s almost like you’re always guilty to the race baiters no matter what you do.
Its like their definition of racism. It’s whatever allows blacks to call whites racist and not have to face the obvious response. It’s only allowed to be used one way. As long as we buy into such a system, they have little incentive to change. And it’s damn hard not to buy into the health care system we’re all forced to pay into.
If discrimination is wrong, and it is, all discrimination is wrong!
As with all statements without description, citing discrimination without definition results in overly broad statements. I choose my friends and what I prefer to eat, both are forms of discrimination which are acceptable. One might even slightly blur the lines between racial and non-racial or religious and secular. But both are socially acceptable to most.
One way to counter this discrimination would be to limit transplants to be within a specific allocate transplants to only occur between members of the same race. I haven’t looked up stats, but I am sure this would leave blacks with the short straw. In the meantime, encourage people to revoke their donor status in protest. If white people will not be treated fairly, then do not donate.
Yeah yeah if you say so, I suppose gravity is wrong too. Discrimination exists, so don’t be the idiot that acts clueless and pretends everyone else isn’t doing it.
These stories always come down to the same thing. The majority involved know it’s stupid, but fear to speak up.
What we need are some popular trendsetters who spread a new, rebellious spirit throughout the land. People should start saying no and simply LAUGH when they are called names. Don’t reason, don’t debate, don’t apologize, just say NO.
Easy answer: “If that’s all you’ve got, you’ve got nothing. Try again.”
.
The problem is that they will be censored, just like happens with the Pale issue.
As someone with one kidney as a result of Renal Cell Carcinoma, I sincerely hope I am never on the list for transplant. I know what people go through in dialysis (not that I’m that far along) and hope I never get that bad. Being between Trump and Biden in age, it isn’t likely that I will so I hope for those younger than I that the latest experimentation with genetically altered pig kidneys works and works very well.
I’m old enough to remember when we had a semi-functional health care system in this country. Now, I won’t these hyper-woke witch doctors put a band aid on a paper cut.
“I’m old enough to remember when we had a semi-functional health care system in this country”
You must be really old!
Smartass 🙂
For the record – 67.
>>This formula change is toxic, and likely to kill White patients.
needlessly.Fixed that for you since the only patients that are likely to die are the White patients in need of a kidney transplant. Oh, and it’s not “likely to kill” White patients but it will kill White patients in favor of blacks.
Perhaps White people can specifically state in their Wills and other legal medical documents that any organs removed for transplant purposes are to be used only for transplantation into a White patient in need of that organ and that blacks need not apply.
Good idea, but they would just cheat.
It seems as if some here at LI would prefer to have White people not donate kidneys to counter this DEI driven change for kidney allocation. Have you considered the effect that this would have on the number of kidneys available for patients of any ethnicity?
Another suggests that White people designate their kidneys for Whites only,,
These “solutions “ are tribal cries that separate us. Do any of you have a
Black family member, friend, co-worker etc. ? Would you wish to withhold or hinder a kidney because some NGO ideologue has made a decision that tips the scales to the detriment of Whites?
We need to work logically and incessantly to reverse this change , not knee jerk negativity..
White, one kidney, compromised GFR,
Blacks are very tribal and most racist in America today. There are consequences for this. I know this is not all black people. But those acting this way are destroying good will at a staggering rate.
Since persecution of Zimmerman, and so may others, my perception of blacks has changed. I look at the big picture, crime, and now there is very little sympathy.
But you do no good if you’re adopting the “kumbaya” line. And it may not be the path to survival. We should first change our behavior, then work to convince the deciders that we won”t be back until they fix this. A beg (I won’t call it a carrot) and a stick work much better than just a beg.
The point of a protest is to get people in power to reconsider their actions.
Please. Stop your racism. Once a day should be sufficient.
What is racist about this? If white people are not properly represented on the kidney donor/donee rolls, why should white people keep donating their organs? It makes sense to me. I mean if there were suddenly a rule that cute redheads in fuzzy slippers couldn’t receive a blood transfusion (because redhead! or fuzzy!), then this cute redhead would stop donating her blood . . . or more likely set up a blood donor organization only for redheads with a penchant for fuzzy slippers. That’s where all this EVERYONE’s A BIG FAT RAAAACIST crap is going, you do get that, right?
Yep. All gingers unite to fight the rampant anti redhead discrimination we face daily as part of the melanin challenged community. Not quite sarcasm b/c there is some low level hate towards us gingers.
Hee!
JR, you are the one who is racist.
“Your equality is racism. My racism is equity.” — Democrats everywhere
White people higher risk for skin cancer. Medical system is racist against whites. Black people need to help pay the dermatologist bill for white people, because equity.
This is why everyone should oppose government-run healthcare.
The product of DEI is always MEDIOCRITY!!!!!!! Never forget it!!!!!
You mean to tell me that if you accept lower qualified students into a program, they won’t turn into geniuses by the time they graduate?
That is unheard of! That would mean that accepting the best qualified students into medical school would lead to more qualified doctors.
People thinking of donating a kidney for whatever reason should know this. It might change their willingness, it might not, but they should make the decision with this information. Perhaps black potential donors will be more likely to donate.