OSU Wexner removes race from GFR equation

COLUMBUS, Ohio — Rosevine Azap has always wanted to make an impact in the world of medicine. She started getting close to medicine as early as she could.

An internship at the Cleveland Clinic led her to medical school at Ohio State University. On her journey through the world of medicine, she realized science didn’t come without bias.

During her internship at the Cleveland Clinic, she had the chance to witness a kidney transplant surgery, which was when she learned about glomerular filtration rate, or GFR, a way to measure kidney function.

After the surgery, she asked the physician she was shadowing why the patient had two numbers on her chart under the GFR column.

“There was a study in 1999 that looked at different patients from different races and ages and things like that, and they determined that Black patients had a higher GFR as compared to other patients, so there is GFR for Black patients and a GFR for everyone else,” said Azap. 

Azap didn’t understand why race was still a factor more than two decades later. The aspiring surgeon, now a third-year medical student at Ohio State, has patients of her own and can see the impact.

She felt positioned to make an impact.

“One of the things we look at for patients that might need a kidney transplant, is how well their kidneys are functioning, how good their GFR is, and for Black patients, if we’re seeing that their GFR is higher than other people then we might be delaying their access to care,” said Azap. 

Azap serves as the president of the student council for OSU’s medical school. She brought her concerns to the September deans meeting and worked with advisers and doctors to add Wexner Medical Center to the list of hospitals that have removed race from the GFR equation.

She worked closely with Dr. Leon McDougle, Dean of Diversity and Inclusion at the med center. When other doctors heard of their work, they were proud.

Dr. Jason Prosek said it gave him a chance to reevaluate the type of doctor he wanted to be.

“When you’re in it you’re not as prepared or good at trying to fix some of those biases until you get that outside influence and someone to say, ‘Hey Dr. Prosek, this doesn’t make any sense, why do we do this?’” said Prosek. “I think the folks like me get asked that enough times you say you know what, this doesn’t make any sense and I’m tired of defending it, let’s go back to the drawing boards.” 

After months of working and advocating for the change, Ohio State announced it would officially remove race from its GFR equation as of Feb. 1.

Azap said she’s seen firsthand the downward effects bias can have in health care, and hopes the change will be one of many moves to more fair medicine.

“Now that I’m in a position where I understand the disparities and I’ve seen it firsthand, I’ve witnessed it, I believe that I’m perfectly positioned to continue advocating for patients, so that way we can all have the best health care possible.” 

Wexner Medical Center also worked with Nationwide Children’s Hospital on making the change. Both hospitals join the list with hospitals in California, New York, Maryland and Washington.