Lawsuit Challenges UC Hospitals' Race-Based Kidney Function Scores
A patient sued UC hospitals over race-based kidney function scores that delayed Black patients' transplant eligibility.
Why it matters: This lawsuit spotlights the legal and ethical debates on race-based medical algorithms, potentially reshaping patient care policies and health equity standards.
- The complaint alleges UC hospitals overstated Black patients' kidney function using race-adjusted eGFR scores.
- OPTN policy in Dec 2022 mandates hospitals backdate wait times for Black transplant candidates affected by race-inclusive eGFR.
- UC Davis Health removed race from eGFR tests in May 2021, ahead of many systems nationally.
- The DOJ found UC medical schools unlawfully used race in admissions, highlighting broader race-related equity challenges.
A patient has filed a lawsuit against University of California system hospitals, alleging that race-based adjustments to the estimated glomerular filtration rate (eGFR) artificially inflated kidney function assessments for Black patients. This overestimation delayed their eligibility for kidney transplant waitlists, according to court filings.
The eGFR test, a clinical standard for assessing kidney function, historically included a race adjustment that assigned higher eGFR values to Black patients. Critics argue this practice has contributed to health disparities by postponing timely access to transplants for Black patients.
Reflecting these concerns, in December 2022, the Organ Procurement and Transplantation Network (OPTN) Board of Directors approved a policy requiring hospitals to reassess their transplant waiting lists. Hospitals must backdate waiting times for Black patients disadvantaged by the previous race-inclusive eGFR calculations, per OPTN's official guidance.
Proactively, UC Davis Health eliminated race from the eGFR calculation in May 2021, one of the first health systems nationally to remove the race adjustment, as noted in official statements.
Meanwhile, the Department of Justice has found that several UC medical schools, including UCLA, UC San Francisco, UC Davis, and UC San Diego, unlawfully considered race during admissions decisions, violating Title VI of the Civil Rights Act. This finding underscores ongoing legal scrutiny of race-based policies across UC institutions (LA Times report).
Experts caution that while race-free eGFR calculations can help reduce disparities, kidney transplant eligibility decisions involve multiple factors beyond eGFR alone. This lawsuit brings renewed attention to how race factors into clinical algorithms and medical decision-making, with ramifications for law and health equity.
By the numbers:
- Dec 2022 — OPTN mandated waiting list reassessment and backdating for disadvantaged Black kidney candidates
- May 2021 — UC Davis Health eliminated race from eGFR calculations
Yes, but: While removing race from eGFR calculations aims to reduce disparities, kidney transplant decisions consider multiple clinical factors beyond the eGFR score alone, complicating the issue.
What's next: The lawsuit's progression could set important legal precedents for race-based medical practices and influence evolving health equity policies within academic and hospital systems.