Kidney Disease Among African Americans: A Population Perspective

Abstract

End-stage kidney disease and earlier stages of chronic kidney disease (CKD) represent one of the most dramatic examples of racial/ethnic disparities in health in our nation. African Americans are 3 times more likely to require renal replacement therapy then their non-Hispanic white counterparts. This article describes CKD-related disparities linked to a variety of clinical, socioeconomic, and cultural factors, as well as to select social determinants of health that are defined by social positioning and often by race within the United States. Our advancing understanding of these issues has led to improvements in patient outcomes and is narrowing the gap in disparities across most aspects of CKD and CKD risk factors. There are also extensive data indicating similar improvements in quality measures for patients on dialysis therapy. This article also reviews the state of CKD in African Americans from a population perspective and provides recommendations for the way forward.

Keywords: African American; Chronic kidney disease (CKD); disparities; ethnicity; health behaviors; health beliefs; population health; race; review; risk factor; social determinants; socioeconomic status (SES).

Figure 1.

Major domains contributing to racial differences and disparities in quality of care and clinical outcomes for patients with chronic kidney disease. Based on a conceptual model in Smedley et al.