Disparities in the burden, outcomes, and care of chronic kidney disease

被引:90
作者
Crews, Deidra C. [1 ,2 ]
Liu, Yang [1 ,2 ]
Boulware, L. Ebony [2 ,3 ,4 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Med, Div Nephrol, Baltimore, MD 21205 USA
[2] Johns Hopkins Med Inst, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD 21205 USA
[3] Johns Hopkins Univ, Sch Med, Dept Med, Div Gen Internal Med, Baltimore, MD 21205 USA
[4] Duke Univ, Sch Med, Dept Med, Div Gen Internal Med, Durham, NC 27706 USA
基金
美国国家卫生研究院;
关键词
kidney transplantation; race; socioeconomic status; renal; ethnicity; STAGE RENAL-DISEASE; RACIAL-DIFFERENCES; UNITED-STATES; ESTIMATED GFR; SOCIOECONOMIC-STATUS; ABORIGINAL PEOPLE; HEALTH-CARE; ESRD; STROKE; APOL1;
D O I
10.1097/01.mnh.0000444822.25991.f6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review Racial, ethnic and socioeconomic disparities in chronic kidney disease (CKD) have been documented for decades, yet little progress has been made in mitigating them. Several recent studies offer new insights into the root causes of these disparities, point to areas in which future research is warranted, and identify opportunities for changes in policy and clinical practice. Recent findings Recently published evidence suggests that geographic disparities in CKD prevalence exist and vary by race. CKD progression is more rapid for racial and ethnic minority groups compared with whites and may be largely, but not completely, explained by genetic factors. Stark socioeconomic disparities in outcomes for dialysis patients exist and vary by race, place of residence, and treatment facility. Disparities in access to living kidney donation may be driven primarily by the socioeconomic status of the donor as opposed to recipient factors. Recent studies highlight opportunities to eliminate disparities in CKD, including efforts to direct resources to areas and populations where disparities are most prevalent, efforts to understand how to best use emerging information on the contribution of genetic factors to disparities, and continued work to identify modifiable environmental, social, and behavioral factors for targeted interventions among high-risk populations.
引用
收藏
页码:298 / 305
页数:8
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