Kidney Disease

Style News Wire | 6/11/2008, 7 p.m.
KIDNEY DISEASE (Nephritis) The inflammation of the kidney. The word comes from the Greek nephro- meaning "of the kidney" and ...

Nephritis has the effect of damaging and closing up the microscopic filters in the kidney. This means that in addition to various toxic waste products, the inflamed kidney filters out important proteins (larger molecules) from the blood. Therefore the characteristic symptom of nephritis is proteinuria — meaning the excessive removal of protein from the blood and its excretion in urine.

HEALTH STATISTICS FOR MINORITIES

Kidney disease has a disproportionate impact on certain racial and ethnic groups, especially African Americans and American Indians or Alaska Natives. African Americans have the highest overall risk of chronic kidney disease. The reasons are not entirely explained by the higher number of persons in this population who have diabetes and high blood pressure. On average, African Americans develop end-stage kidney failure at an earlier age than whites (55.8 years compared to 62.2 years). American Indians or Alaska Natives have a much higher risk of chronic kidney disease due to diabetes than whites. Overall, the rates of new cases are 4 times higher in African Americans and American Indians or Alaska Natives and 1.5 times higher in Asians or Pacific Islanders than in whites.

Annual increases in end stage renal disease (ESRD) rates are greater in certain racial and ethnic populations than in white populations. Rates of new cases are increasing by 7 percent per year for African Americans, 10 percent per year for American Indians or Alaska Natives, and 11 percent for Asians or Pacific Islanders, compared to 6 percent per year for whites. Although complete data are not yet available, some evidence indicates that persons of Mexican ancestry also may have a high risk of developing chronic kidney failure, particularly due to diabetes.

Renal transplantation is an important lifesaving renal replacement therapy and has been shown to offer many advantages when compared with dialysis; however, racial and ethnic disparities exist. Between 1994 and 1997, the first cadaveric transplantation rates (per 100 patient years) in the pediatric age group were 31 for black males, 28 for white males, 19 for black females, and 26 for white females. For recipients between the ages of 20 and 44 years, the rates were 7 for black males, 17 for white males, 7 for black females, and 15 for white females. In the 45- to 65-year age group, the rates were 4 for black males, 8 for white males, 2 for black females, and 6 for white females.

Reasons for the racial and ethnic disparities in the rate of transplantation are varied and include differences in finding human leukocyte antigen matches, cultural attitudes and beliefs on the part of both patients and health care providers, socioeconomic status, rates of organ donation, and geographic location.

Kidney transplantation has emerged as the preferred therapy for many patients with treated chronic kidney failure, particularly children; however, certain racial and ethnic groups and women consistently have longer waiting times and lower rates of kidney transplantation than white males.

QUICK FACTS

• In 1996, African Americans constituted 12.6 percent of the U.S. population but 29.8 percent of ESRD patients; American Indians or Alaska Natives constituted 0.9 percent of the U.S. population but 1.7 percent of those receiving renal replacement therapy.

• Major risk factors for the development and progression of chronic kidney disease include diabetes, high blood pressure, environmental exposures, proteinuria, family history of kidney disease, and increasing age.

• In its early stages, Kidney disease is generally asymptomatic; therefore, many people who would benefit from these interventions are not identified.

• There is a higher rate of kidney failure in men. In 1997, the incidence of treated chronic kidney failure was 322 per million populations in men, compared with 271 per million in women.

• Three interventions are effective in certain defined populations:

• Glycemic control (for patients with diabetes).

• Blood pressure control (for patients with high blood pressure).

• Use of angiogenesis-converting enzyme (ACE) inhibitors.

• Interventions to slow the progression of kidney disease and prevent chronic kidney failure are likely to have the greatest impact if applied early in the course of the disease.

WEB SITE RESOURCES

• To take an at-risk quiz http://www.kidney.org/news/wkd/kidneyQuiz.cfm

• http://www.kidney.org/news/newsroom/newsitem.cfm?id=370