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an anatomical image of a kidney

Jordan Crowley was born with only one shrunken kidney to clean his blood. As he gets older, his one kidney gets sicker.

Jordan is now 18, loves dogs, and is more interested in telling me about his college classes than the fact that he was recently hospitalized for seizures, a complication of his illness. He’ll need a kidney transplant soon. He would be closer to getting that kidney transplant, if only he were categorized as white.

A patient’s level of kidney disease is judged by an estimation of glomerular filtration rate, or eGFR, which normally sits between 90 and 120 in a patient with two healthy kidneys. In the United States, patients can’t be listed for a kidney transplant until they’re deemed sick enough—until their eGFR dips below a threshold of 20.

Jordan is biracial, with one Black grandparent and three white ones. His estimated GFR depends on how you interpret this fact: A white Jordan has a GFR of 17—low enough to secure him a spot on the organ waitlist. A Black Jordan has a GFR of 21.

Jordan’s...