West Virginia lawsuit demands removal of medical formula that adjusts kidney disease diagnosis by race

Jonte Robinson, 40, was denied early release from prison due to a kidney disease formula that determined his kidneys were healthy, solely because he is Black.

Black Americans continue to make up a disproportionate number of the 37 million U.S. adults with kidney disease. Now, a decades-old formula that determines kidney function based on race is the subject of a West Virginia lawsuit.

The lawsuit, filed in federal court in Washington D.C. by Jonte Robinson is demanding that the Federal Bureau of Prisons stop using the formula and adopt a race-blind equation.

Robinson, 40, is incarcerated at a federal prison in Hazelton, West Virginia and has chronic kidney disease. As reported by the New York Times, his attorneys requested that the bureau stop using the race-adjusted “estimated glomerular filtration rate (eGFR)” test in the lawsuit Wednesday.

When I was a med student, I was taught that Black and non-Black patients had different sets of normal ranges for kidney function.

While that teaching is now outdated, our federal courts still use the old kidney formula to determine early prison release.https://t.co/NBsfnEMfz4

— uché blackstock, md (@uche_blackstock) April 23, 2022

The eGFR equation approximates a kidney function score based on “age, sex, race and/or body weight” according to the National Kidney Foundation. Many experts and health care institutions have renounced the formula due to the fact that race is a social construct unlike the other biological metrics analyzed in the equation.

Robinson’s non-adjusted kidney function scores ranged between 56 and 58, below the cutoff point of 60 points commonly used to indicate a healthy kidney. However, the eGFR adjustment based on Robinson’s race pushed his score above 60, according to the Times.

“Race should not be used to make any biological inferences about individuals,” wrote a team of medical experts in a 2021 scientific journal about the eGFR formula, adding that it may perpetuate racial stereotypes and inequities in health, per the Times.

Federal Judge Randolph D. Moss rejected his request for early medical release, citing his kidney function score which used the aforementioned equation, according to the outlet. Robinson has served “17 years of a 25-year sentence for crimes including aiding and abetting a double murder.”

5/ These race adjustments are especially problematic since, while black Americans compose ~13% of the population that account for 35% of chronic kidney disease. Thus, the race adjustments are dereprioritizing addressing kidney disease in the highest risk population.

— Nick Norwitz 🇺🇦 (@nicknorwitz) April 23, 2022

When Judge Ross declined to release Robinson, he noted that the eGFR formula “may be the subject of dispute.” He also said he had no clarity about Robinson’s kidney health.

“If Mr. Robinson were white his medical data would indicate that he was suffering from chronic kidney disease,” Robinson’s attorneys responded in an appeal filed later in the year, which he lost.

Robinson, who is Black, is one of over 20,000 federal prisoners who have requested early release amid the COVID-19 pandemic, according to the Times.

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