For decades, race has been defined as a biological risk factor for disease processes and outcomes, often with no clear biologic explanation. The debunked “middle passage salt-sparing hypothesis” of the 1990s attributed high rates of hypertension in Black Americans to “natural selection” among those who survived the middle passage,1 and the assumption of higher muscle mass, with racist undertones, has been used to explain differences in serum creatinine.2 In recent years, health equity advocacy efforts and greater appreciation of the profound diversity within racial groups has led to an affirmation that race is not a biological entity, but rather a social construct.