Why do minorities have higher rates of kidney failure?

A new study investigates the reasons behind higher incidences of kidney failure among US minorities. The findings will be presented online during ASN Kidney Week 2020 Reimagined October 19-October 25.

In the United States, Blacks and Hispanics have higher incidences of kidney failure than whites, but it's unclear if this is driven by inherently faster progression to kidney failure or by lower death rates prior to kidney failure (with more Blacks and Hispanics living longer to develop kidney failure).

To investigate, Guofen Yan, Ph.D. (University of Virginia) and her colleagues examined information on 834,270 individuals who were diagnosed with chronic kidney disease (CKD) in the US Veterans Health Administration between 2002 and 2015 and were followed through 2016.

Ten years after CKD onset, the cumulative incidence of developing kidney failure were 1.3-2.5 times greater for Blacks and Hispanics compared with whites across 6 age groups. The kidney failure risk was 2.1-2.9 times greater for Blacks and 1.2-2.7 times greater for Hispanics vs. whites. Risk of death before kidney failure was similar for Blacks and only modestly lower for Hispanics vs. whites across ages.

"Following CKD onset, Blacks and Hispanics were 2 times more likely than whites to develop kidney failure, and this was truly driven by a greater risk of kidney failure due to faster decline in kidney function after CKD onset, rather than because of lower risks of death prior to kidney failure," said Dr. Yan. "Delineation and elimination of the causes of faster kidney function declines in Blacks and Hispanics are therefore the appropriate strategies to improve clinical outcomes in Blacks and Hispanics with CKD. Slowing the faster progression in Blacks and Hispanics with CKD should be a major focus in research, practice, and healthcare policy to achieve the goal of reducing the disparities in CKD."