Study: Kidney Disease A Big Risk For Younger, Low-Income Minorities
Washington, DC — Chronic kidney disease (CKD) afflicts a large
number of younger minority adults receiving medical care in settings that serve the
uninsured and underinsured (settings collectively known as the healthcare safety net).
Poor, minority adults with moderate to severe CKD are also two to four times more likely
to progress to kidney failure than non-Hispanic whites. These are the findings from a
study published online in the Clinical Journal of the American Society of Nephrology
The study indicates that targeted efforts to assess the burden and progression of CKD
within the healthcare safety net are vital to improving the quality of care for this
vulnerable population, and ultimately save lives.
Researchers at the University of Washington, the University of California San Francisco,
and Stanford University examined data from 15,353 adults with non-dialysis dependent
CKD stages 3-5. All were receiving regular ambulatory care in the Community Health
Network of San Francisco and were followed for a period of 12-months to 9.4 years. The
study authors measured the time it took for patients to progress from moderate to
severe CKD to end-stage renal disease (ESRD) or death.
The vast majority of study participants were indigent, 40 percent were either uninsured
or enrolled in Medicaid, and one-third spoke a primary language other than English – all
vulnerable populations which have been underrepresented in prior studies of CKD.
In contrast to the general population and prior CKD studies in the United States, the
study authors found CKD afflicted a large fraction of young adults (20-39 years old),
most of whom were racial or ethnic minorities. Overall, African Americans, Hispanics,
Asians and Pacific Islanders with CKD were at higher risk of developing ESRD,
compared with non-Hispanic whites.
“Minorities in the United States are two to four times more likely than non-minorities to
progress to ESRD,” said Andy I. Choi, M.D., M.A.S., study co-author and assistant
professor, Division of Nephrology, University of California, San Francisco. “That
represents a significant disparity that warrants greater study about the causes,
consequences and preventive measures appropriate for people in this demographic.”
Because so little is known about CKD in the healthcare safety net, the authors call for
additional research to assess what is needed to curb the progression of the disease,
particularly among vulnerable populations. “More targeted research in these public
healthcare and safety net settings is necessary to identify ways to slow the progression
of the disease among the urban poor with CKD, thereby reducing disability and
improving overall survival," said Yoshio N. Hall, M.D., study co-author and assistant
professor of medicine, Kidney Research Institute, Division of Nephrology, University of
“Kidney disease is a growing problem in the United States, doubling in incidence over
the last two decades. It’s serious, and without proper diagnosis and treatment, kidney
disease can lead to expensive treatments like transplantation or dialysis,” said Sharon
Anderson, M.D., FASN, president of the American Society of Nephrology. “Health care
providers need to be especially vigilant screening patients who are most at-risk for
developing kidney disease – minorities, seniors and those who have been diagnosed
with diabetes, hypertension and/or cardiovascular disease."
The study was published in conjunction with World Kidney Day, an international
effort to raise awareness about the growing incidence of kidney disease and the need
for increased funding for kidney disease research and education. Experts say more
research can lead to treatments that could prevent or slow the disease’s progression,
save lives and reduce treatment costs. Currently, more than 26 million Americans, or one
in nine adults, have chronic kidney disease. For more information about kidney disease
and World Kidney Day, visit www.asn-online.org.
The article, entitled “Chronic Kidney Disease in the Urban Poor,” appears online at
http://cjasn.asnjournals.org/ doi 10.2215/CJN.09011209. ASN has released an
accompanying podcast with Dr. Hall, which is available on iTunes and on the
ASN website at www.asn-online.org.
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Founded in 1966, the American Society of Nephrology (ASN) is the world’s largest
professional society devoted to the study of kidney disease. Comprised of 11,000
physicians and scientists, ASN continues to promote expert patient care, to advance
medical research, and to educate the renal community. ASN also informs policymakers
about issues of importance to kidney doctors and their patients. ASN funds research,
and through its world-renowned meetings and first-class publications, disseminates
information and educational tools that empower physicians.
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