Disparities in chronic kidney disease-the state of the evidence

Maya N. Clark-Cutaia, Eleanor Rivera, Christin Iroegbu, Allison Squires

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of review The purpose of this review was to assess the prevalence of United States chronic kidney disease (CKD) health disparities, focusing on racial/ethnic groups, immigrants and refugees, sex or gender, and older adults. Recent findings There are major racial/ethnic disparities in CKD, with possible contributions from the social determinants of health, socioeconomics, and racial discrimination. Racial/ethnic minority patients experience faster progression to end-stage kidney disease (ESKD) and higher mortality predialysis, however, once on dialysis, appear to live longer. Similarly, men are quicker to progress to ESKD than women, with potential biological, behavioral, and measurement error factors. There is a lack of substantial evidence for intersex, nonbinary, or transgender patients. There are also strikingly few studies about US immigrants or older adults with CKD despite the fact that they are at high risk for CKD due to a variety of factors. Summary As providers and scientists, we must combat both conscious and unconscious biases, advocate for minority patient populations, and be inclusive and diverse in our treatment regimens and provision of care. We need to acknowledge that sufficient evidence exists to change treatment guidelines, and that more is required to support the diversity of our patient population.

Original languageEnglish (US)
Pages (from-to)208-214
Number of pages7
JournalCurrent opinion in nephrology and hypertension
Volume30
Issue number2
DOIs
StatePublished - Mar 2021

Keywords

  • COVID-19
  • Chronic kidney disease
  • End-stage kidney disease
  • Health disparities
  • Racial and ethnic minority
  • SARS-CoV-2
  • Sex/gender

ASJC Scopus subject areas

  • Internal Medicine
  • Nephrology

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