ASN Cosponsors Congressional Briefing on Racial Disparities in Kidney Disease

 

Kidney disease affects millions in the United States across all populations, but it is more common among minorities. African Americans, Hispanics, Pacific Islanders, and Native Americans face a disproportionately increased risk for developing kidney disease.

Broadening knowledge about the disparities in kidney care that minorities confront is essential to resolving those disparities. On April 19, 2012, the American Society of Nephrology (ASN), Dialysis Patient Citizens (DPC), and the National Urban League led a congressional briefing on kidney health disparities. Maria Cristina Arce, MD, and Neil R. Powe, MD, addressed members of Congress and Capitol Hill staffers about this critical issue on ASN’s behalf.

A nephrology fellow at Stanford University School of Medicine, Arce presented information on kidney disease in the Hispanic population. She noted that Hispanic ethnicity is associated with an increased risk for end stage renal disease (ESRD) compared with whites—an increase not explained by higher prevalence of diabetes or by diabetes severity. In addition, a higher number of younger Hispanics are starting dialysis, possibly due to worsening rates of obesity, earlier onset of diabetes and hypertension, and faster progression of kidney disease. Hispanics are 15 percent less likely to use arteriovenous access for their first hemodialysis session, Arce said.

Powe spoke to the audience at the congressional briefing about the many factors that contribute to a rate of kidney failure in minorities that is up to four times greater than in whites. Chief of Medicine at San Francisco General Hospital and Vice-Chair of Medicine at the University of California San Francisco, Powe noted that kidney disease occurs more often in minorities and starts earlier. Socioeconomic status, lifestyle and quality of care explain 44 percent of the threefold excess risk of chronic kidney disease (CKD) in African Americans compared to whites. African Americans are also much less likely to get transplants or to be placed on the transplant waiting list, said Powe. His presentation echoed Arce’s findings that minorities in the United States are referred to nephrologists much later than whites.

Powe emphasized to lawmakers the current and future opportunities for the federal government to address racial and ethnic disparities in kidney care. These include comparative effectiveness studies of treatment in minorities, enhanced patient and provider education, and increasing support for demonstration projects to assess the effectiveness of changes in health care.

DPC board member Eric Edwards spoke to those assembled about living with kidney disease. Also presenting at the briefing were Kafui Agbemenu, Health Advocate for the Urban League, who spoke about how the Urban League in Pittsburgh is improving minority access to health care. Dana Atwater of Baxter Healthcare presented general information on CKD in the United States.

The American Society of Nephrology supports a variety of efforts to address and resolve disparities in kidney care in the United States and worldwide, including support of Senate bill 2163 that promotes research regarding disparities and access to care. ASN encourages members to contact your members of Congress to support this bill at http://capwiz.com/asn/home.

May 2012 (Vol. 4, Number 5)