Estimated reading time: 5 minutes
Lately, kidney disease has emerged as a critical public health concern in the United States. The chronic kidney disease in Black American populations is disproportionately high. The CDC states that Black Americans have 4 times the incidence of kidney failure as White persons.
Today we will explore the intersection of science and societal factors that contribute to the increase kidney health risks faced by Black Americans.
Societal and Environmental Factors
Renal disease encompasses a number of conditions that affect the kidneys. The kidneys are vital organs responsible for filtering waste and excess fluids from the blood. Chronic kidney disease is a prevalent form of renal disease that often leads to severe complications, including kidney failure. But how do societal and environmental factors play a role?
Socioeconomic Disparities
Statistics paint a grim picture: Black Americans are approximately three times more likely to develop kidney failure compared to their white counterparts. This highlights the deeply rooted issue of socioeconomic disparities, one of the primary contributors to the heightened prevalence of renal disease among Black Americans.
Factors such as:
- Limited access to quality healthcare,
- Educational opportunities,
- And economic resources
The difference in access to these resources and opportunities make it harder for some people to stay healthy or get the medical care they need. For example, if someone doesn't have health insurance or the money for care, they are not going to see a doctor when they need to. Or if they live in an area that doesn't offer a good grocery store, it is harder to find healthy food. These challenges can lead to more health problems and increases the likelihood of having more than one medical condition like diabetes and hypertension. Which happen to be major risk factors for those living with renal disease.
How Can PatientsLikeMe Help?
PatientsLikeMe addresses these barriers by offering a free platform where members can put their experiences living with a kidney disease in context, connect with members living with the same condition, and find answers to their questions. Data generated by members are systemically collected and quantified while also providing an environment for peer support and learning. We are also enabling and encouraging members to improve self care, reduce avoidable ER visits, make more informed healthcare choices, improve treatment adherence, and sustain behavioral change that is critical to so many health conditions, including renal disease.
Stress and Lifestyle Influences
Chronic stress, often linked to systemic racism and socioeconomic disparities, can contribute to the development and progression of renal disease. The specter of systemic racism looms large over the healthcare system. This leads to disparities in the quality of care received by different racial and ethnic groups. Black Americans often face barriers such as implicit biases, unequal treatment, and limited access to preventive services. All of these can contribute to delayed diagnosis and inadequate management of conditions.
Access to resources such as nutritional education and support programs, mental health services, community based health screenings, and affordable medications are all part of a multifaceted approach to a more equitable and inclusive healthcare system.
Genetic Predispositions
Genetic studies have show a an association between the Apolipoprotien L1 (APOL1) gene with the increased risk of non-diabetic endstage kidney disease (ESKD) in Black Americans. Other diseases such as sickle cell are also associated with the development of chronic kidney disease. There are also biological responses such as obesity, depression, stress, and diabetes that are not specifically associated with Black Americans.
APOL1 Gene Variants
One of the key genetic factors contributing to the elevated prevalence of renal disease in the Black population is the presence of specific variants in the APOL1 gene. Individuals carrying two copies of these variants have an increased risk of developing focal segmental glomerulosclerosis (FSGS). They can also get hypertension-attributed end-stage kidney disease (H-ESKD). The prevalence of these risk alleles is notably higher in individuals of African descent, emphasizing the genetic component of renal disease disparities.
Genetic Susceptibility to Hypertension and Diabetes
Genetic variations also play a role in the heightened susceptibility of Black individuals to hypertension and diabetes, both major contributors to renal disease. Variants associated with salt sensitivity, endothelial function, and insulin resistance are more prevalent in the Black population, underscoring the intricate interplay between genetics and renal health.
Finding a Path Forward
By bridging the gap between science and society, we can pave the way for more effective prevention and management strategies. Ultimately we can work towards a future where renal health disparities are significantly reduced.
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