Kidney Algorithm Change Helps 5,400+ Black Patients Get Care

For decades, a flawed medical calculation kept thousands of Black patients from getting the kidney transplants they desperately needed.

Until 2021, doctors used a formula that artificially inflated kidney function scores for Black patients by up to 21%. This made their kidney disease look less severe than it actually was, pushing them further down transplant waiting lists while their health deteriorated.

In 2022, nephrologists made history by removing race from the equation entirely. The Organ Procurement and Transplantation Network then did something unprecedented: they ordered transplant programs to go back and fix the harm done to Black patients already waiting for kidneys.

A new study published in JAMA Internal Medicine shows the policy delivered real results. The change affected 27% of Black patients on transplant lists and led to 5.3 additional transplants per 1,000 Black candidates. Since the policy launched, more than 21,000 people have received adjusted wait times.

Researcher Rohan Khazanchi from Boston Medical Center calls it "the first time that's been done on a national scale." His team examined data from over 180,000 transplant candidates, including 56,000 Black patients, comparing outcomes before and after the 2023 policy took effect.

Critics had warned that helping Black patients would harm others in a zero-sum game. The data proved them wrong: non-Black patients did not have lower odds of receiving transplants during the study period.

The Ripple Effect

The kidney algorithm victory is opening doors across medicine. Health equity advocates hoped it would inspire other specialties to examine their own race-based formulas, and conversations are now happening around lung function tests that impact worker compensation payouts.

Nephrologist Vanessa Grubbs, who founded Black Doc Village, remembers the battle to change the formula. "I was honestly surprised at how much people were fighting this," she said. "Some folks were saying it's not going to resolve disparities in kidney disease, and here we have some evidence of how it does."

The policy doesn't solve every problem. It mainly helped patients who already had regular medical care and documented lab values, not those who got sick suddenly. Khazanchi says there's more work ahead to address those remaining gaps.

But the success proves that reparative medical policies can work when institutions commit to undoing past harms. LaVarne Burton, president of the American Kidney Fund, calls the results "deeply meaningful" for the thousands who've already benefited and a model for making transplantation fair for everyone facing kidney failure.

Medical equity isn't just possible—it's measurable, achievable, and doesn't require anyone else to lose.