NEW YORK (Reuters Health) - One reason that African Americans have high rates of kidney failure is that earlier, treatable stages of kidney disease are not being recognized in this population, according to findings from the Jackson Heart Study reported in the American Journal of Kidney Diseases for February.
The report, conducted in Jackson, Mississippi, found that only about one in six African-Americans with chronic kidney disease was aware of the condition.
“Much of the problem of patient awareness is due to a lack of awareness of medical practitioners” who continue to adhere to out-dated standards of kidney function, Dr. Michael F. Flessner, at the University of Mississippi Medical Center in Jackson, said in a prepared statement. “Most physicians were trained in an era in which serum creatinine was used as an absolute indicator of kidney disease.”
Although kidney disease has reached epidemic proportions in the US, African Americans are particularly affected, with rates of end stage renal disease four times higher than among Caucasians, the authors point out.
The current analysis included more than 3400 African American adults who were interviewed and underwent physical examinations, including assessment of urine levels of albumin and creatinine. They were also asked whether they were being treated with dialysis or whether they had ever been told by a health care professional that they have kidney disease.
“The vast majority of the JHS group, who had insurance and at least a high school education, did not know they had chronic kidney disease and were not being properly treated,” Flessner and co-investigators report.
Overall, 20 percent of subjects had chronic kidney disease, but very few of those affected - fewer than 16 percent — knew so.
The problem appears to be limited to kidney disease, since most people who had diabetes, hypertension, or high cholesterol were aware of those diagnoses.
“It is imperative,” the authors stress, “that new approaches be implemented to increase awareness, diagnosis, and treatment for both the health care provider and the patient.”
That need is now being addressed by multiple organizations, Flessner noted in his statement. “The National Kidney Foundation, the American Society of Nephrology, and the National Institute of Health’s National Kidney Disease Education Program are beginning to have an impact on this lack of awareness at the practitioner level.”
SOURCE: American Journal of Kidney Diseases, February 2009.