Kidney Health

March is National Kidney Month.

Kidneys filter blood, remove waste to make urine, control blood pressure, and regulate hormones. Damaged kidneys limit the body’s ability to filter blood and causes waste to build up in the body. More than 26 million U.S. adults have been diagnosed with kidney disease. The risk factors for kidney disease are: diabetes, high blood pressure, cardiovascular disease, and a family history of kidney failure. If kidney disease is detected early, treatment might be available to delay or prevent kidney failure.

End stage renal disease (ESRD) is the last stage in the  progression of kidney disease and usually requires dialysis or a kidney transplant. Dialysis generally require three treatments a week, each lasting 3-4 hours. In the United States in 2010, 580,741 people were living with ESRD. Since Chronic Kidney Disease and ESRD generally impact Americans who are older and on Medicare, the economic cost for the public is high. Kidney disease costs Medicare about $41 billion a year in treatment.  

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Kidney Health Disparities

Chronic Kidney Disease and End Stage Renal Disease disproportionately affect minority communities. African Americans are 3.6 times more likely to have kidney failure compared to the general population. While African Americans are about 13 percent of the U.S. population, 32 percent of the people with kidney failure are African American. Hispanic Americans and Native Americans are also at increased risk compared to the general public. Since 2000, the number of Hispanics with kidney failure has increased by more than 70 percent.

Kidney disease is also linked to higher levels of poverty, especially in African Americans. Study results show that African Americans who had incomes less than $20,000 were three times more at risk for kidney disease that African Americans earning more than $75,000.  

Not only are racial minorities more likely to have kidney disease, they are more likely to die from it. Nearly 70,000 patients are on the waiting list for kidney transplants, with African Americans comprising 35% of these patients. In addition, minorities that do get kidney transplants are more likely to spend more time on the waiting list than whites.

Why the huge disparities?

Like many other diseases, the reason for the kidney health disparities is largely environmental. Diabetes is a leading cause of kidney disease, and minorities and those living in poverty are more likely to be diagnosed with diabetes than the general American population. In 2009, diabetes caused 38.4 percent of all kidney failure. The reason for the higher rates of diabetes among minorities may be attributed to lack of health services within minority communities, limited supply of nutritious foods, lack of safe places for exercise, and chronic sources of stress such as community violence and financial instability.

Another reason for the disparities in kidney disease is that historically, in the United States, there has been a racial disparity in who received organ transplants. Matches across race are more difficult and a higher proportion of organ donors are white while a higher proportion of those needing kidneys are black. Therefore more racial minorities die waiting for a kidney transplant.

Decreasing the burden of kidney disease

The Affordable Care Act will provide more Americans with access to preventative health services. For many people, diabetes, a leading cause of kidney disease, can be prevented through adequate diet and exercise. Access to insurance can also provide those with beginning stages of kidney disease treatments to delay the progression of the disease to kidney failure. Early diagnosis is the key and for a diagnoses, individuals must have a health care provider who is easily accessible and trusted. General awareness about kidney disease is also important, especially within minority communities. Many people who already have diabetes or high blood pressure are not aware of their increased risk of kidney disease. Even more alarming, a study in Mississippi found only one in six African-Americans found to have Chronic Kidney Disease was aware of having the condition. In honor of National Kidney Month, consider becoming an organ donor.