Early detection essential to controlling the condition
By Robin James
Eliminating health disparities is hard work, particularly when it comes to tackling the list of disparities directly related to the African American population. Chronic kidney disease (CKD) is linked to that list of health challenges. The Centers for Disease Control (CDC) has designated March as National Kidney Month to raise awareness about the prevention and early detection of kidney disease, which can lead to kidney failure.
The risk of kidney disease is linked directly to higher rates of diabetes and high blood pressure, two of the leading causes of kidney disease. This increase is thought to be closely linked to rising rates of obesity.
We know that obesity is also a major health issue for African Americans, but what may be less well known is that CKD statistics indicate that more than 20,000 U.S. adolescents and teens now have type 2 diabetes, up from almost none 20 years ago, according to the American Diabetes Association. Even worse, unless prevention strategies are adopted, the number of American youth with type 2 diabetes could quadruple by 2050, increasing their risk for chronic kidney disease.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, kidney failure affects the African American population at nearly four times the rate of the general population. There’s a good chance that you may know someone who faces CKD, has had a kidney transplant, or is living on dialysis, which results from the development of kidney failure.
The MSR interviewed Dr. Eric Schneider (ES), a nephrologist (kidney specialist) and medical director for Fresenius Medical Care, about CKD education and awareness.
MSR: We’re interested in learning more about chronic diseases such as chronic kidney disease (CKD) and its effects on the African American population. It’s just one more health disparity to eliminate among this demographic. What do you think is the root cause of chronic kidney disease?
ES: Chronic kidney disease (CKD) can be caused by many things, but the main causes in the U.S. are diabetes and high blood pressure.
MSR: Why is it important to be tested for chronic kidney disease, particularly if you are African American?
ES: An estimated 26 million people in this country — one in nine Americans — have CKD, but most don’t know it because there are usually no symptoms in the early stages of kidney disease.
Chronic kidney disease hits ethnic minorities disproportionately. African Americans are nearly four times more likely than the general population to develop CKD. This is largely because there are higher incidences of diabetes and high blood pressure, the two leading causes of CKD, among African Americans.
MSR: Although there are usually no symptoms during the early stages, what are some strategies for successfully reducing your chances of developing chronic kidney disease?
ES: If you think you may be at risk for CKD, get tested. To find out how, consult your doctor, and ask about free local screenings. By far the best strategy for reducing one’s chances of developing chronic kidney disease is to establish medical care with a primary care provider and get tested for diabetes and high blood pressure.
If you have these conditions, you should be followed closely by a physician/ healthcare provider to optimally control these conditions so they do not lead to kidney damage. If you have a family history of kidney disease, it is important to discuss this with a physician/healthcare provider to determine if you are at risk for developing CKD.
MSR: To achieve reductions in the occurrence of African Americans with chronic kidney disease, what educational outcomes should be expected if we are to properly tackle this growing epidemic?
ES: I want to emphasize the role of early detection of conditions such as diabetes and high blood pressure in both prevention and management of CKD. In my practice as a nephrologist, it’s far too common that I become involved in the care of patients who either are not aware they have high blood pressure or diabetes, or know they have the condition, but do not manage it effectively. One of the most rewarding parts of my job is when I meet someone who has early CKD and we are able to either manage/control the disease or slow the progression.
CKD can be slowed if caught in the early stages. If you think you may be at risk for CKD, get tested. Some people can live with kidney disease under a doctor’s care for a long time before they reach end-stage kidney disease, while others progress more quickly. In either case, it’s important to attend your medical appointments and talk regularly with your healthcare team.
MSR: What assessments, if any can be made in order to identify chronic kidney disease early?
ES: Detection of kidney disease can be as simple as a blood test that checks the function of the kidneys and a urine test that looks for protein leakage, which can be a sign of damage to the kidneys. If you have diabetes, high blood pressure, or a family history of kidney disease, it’s important to talk with your doctor and get tested. The earlier chronic kidney disease is detected, the better the chance of slowing its progression.
MSR: What interventions can be done to inform more African Americans about chronic kidney disease?
ES: I encourage community-based education strategies that highlight the causes of CKD as well as emphasize the increased risk for African Americans of developing CKD due to higher rates of diabetes and hypertension in this population.
MSR: Describe what has been the acceptability of treatment for chronic kidney disease among your African American patients.
ES: Similar to the treatment of all diseases, the acceptability varies from patient to patient. This is true for all patients, not just among African Americans.
Effective education strategies highlighting the importance of early detection of diabetes, high blood pressure and CKD are critical and can motivate people to manage their health and lead healthy lifestyles.
For more information, visit Kidney Specialists of Minnesota (KSM) at www.kidney-mn.com, or Dr. Eric Schneider, Fresenius Medical Care Medical Director, at www.ultracare-dialysis.com.
Robin James welcomes reader responses to [email protected].