内容摘要：Kosher salt and freshly ground black pepper (to taste)

Kosher salt and freshly ground black pepper (to taste)

Black Americans are over three times more likely than white people to experience kidney failure. Of the roughly 89,000 people currently on the waiting list for a new kidney, about 30% are Black.Race isn’t a biological factor like age, sex or weight — it’s a social construct. So how did it make its way into calculations of kidney function?

The eGFR, or estimated glomerular filtration rate, evaluates kidney health based on how quickly a waste compound called creatinine gets filtered from blood. In 1999, an equation used to calculate eGFR was modified to adjust Black people’s results compared to everyone else’s, based on some studies with small numbers of Black patients and a long-ago false theory about differences in creatinine levels. Until recently that meant many lab reports would list two results — one calculated for non-Black patients and another for Black patients that could overestimate kidney function by as much as 16%.Not every Black kidney candidate was affected. Some may have had kidney failure diagnosed without that test. For others to have a chance at benefitting from UNOS’ mandated lookback, transplant center staff-turned-detectives often worked after hours and weekends, hunting years-old records for a test that, recalculated without the race adjustment, might make the difference.“You’re reaching out to the nephrologist, their primary care doctors, the dialysis units to get those records,” said Dr. Pooja Singh of Jefferson Health’s transplant institute in Philadelphia, where Evans received her new kidney. “That first patient getting transplanted for us was such a great moment for our program that the work didn’t feel like work after that.”

A high school sports physical first spotted Evans’ kidney disease at age 17. While finishing her master’s degree and beginning to earn her Ph.D. at Temple University, she started dialysis — for nine hours a night while she slept — and was placed on the transplant list.How long it takes to get a kidney transplant depends on patients’ blood type, medical urgency and a mix of other factors — including how long they’ve spent on the waiting list. Evans was first listed in April 2019. When the Jefferson transplant center unearthed her old lab tests, they found she should have qualified in September 2015.

“Just for context, when I was still an undergrad I should have been on the list,” she said, recalling the anger she felt as she read the letter. What she called “a mind-blowing” credit of 3½ more years waiting also provided “a glimmer of hope” that she’d be offered a matching kidney soon.

Evans got a new kidney on July 4 and is healthy again, and grateful the policy change came in time for her.The Liberty head home to play a pair of games against expansion Golden State on Tuesday and Thursday. Indiana is at Washington on Wednesday.

NEW YORK (AP) — The U.S. Department of Agriculture announced that students eligible for free or reduced price school meals cannot be chargedSchool districts currently work with processing companies to offer cashless payment systems for families. But the companies can charge “processing fees” for each transaction. By law, students who are eligible for reduced price meals cannot be charged more than 30 cents for breakfast and 40 cents for lunch. With processing fees, however, families can end up paying 10 times that amount. Processing companies charge as much as $3.25 or 4% to 5% per transaction, according to a recent report from the Consumer Financial Protection Bureau.

For families with lower incomes who can’t afford to load large sums in one go, processing fees can arrive weekly or even more frequently, increasing costs disproportionately. Families that qualify for free or reduced lunch pay as much as 60 cents per dollar in fees when paying for school lunches electronically, according to the report.The new Agriculture Department’s policy becomes effective starting in the 2027-2028 school year. With this rule, the USDA will lower costs for families with income under 185% of federal poverty guidelines, which equals $57,720 for a family of four.