Risks for CKD in African Americans

 Did you know African Americans are at increased risk of developing chronic kidney disease leading to dialysis and transplant? Compared to other ethnic groups, the African American population has higher rates of diabetes and high blood pressure, which are the two leading causes of kidney disease.

Almost one in every three African Americans has high blood pressure. Because there are no warning signs, frequently people have high blood pressure or kidney disease and don't even know they have a health problem. Even diabetes doesn't always have symptoms. This is why it is important to have regular physicals or screening for high blood pressure and diabetes. If you get a clean bill of health, follow a healthy lifestyle to prevent getting a disease. If you find out you have diabetes and/or high blood pressure, be sure to discuss your condition with your doctor. Follow your doctor's advice and remember to take all prescribed medications.

Many African Americans already know they have diabetes or high blood pressure, but are not aware they may also have kidney disease. They are shocked to be diagnosed with kidney failure and then immediately begin dialysis. Even though their kidney disease progressed over time to kidney failure, it's as if it happened all of a sudden.

Other factors that can lead to kidney failure include, drug abuse, HIV and sickle cell disease.

When you are diagnosed early with any of the diseases that may lead to kidney disease, you can do your part to prevent or delay kidney failure and decrease the risks of serious complications. When kidney failure happens, dialysis or kidney transplant are the only treatment options.

Advanced awareness is the key to better health. Make February the month you find out your health risk for kidney disease. Take a look at these staggering statistics and share this information with African American family members and friends . Then make an appointment to get checked and know your numbers.

Statistics regarding African Americans and Chronic Kidney Disease

• Out of one million people, 777 African Americans compared with 269 white Americans experienced kidney failure in 2002.
• African Americans make up only about 13% of the U.S. population, yet constitute 32% of patients treated for kidney failure.
• African Americans are seven times more likely to get kidney disease compared to white Americans.
• African Americans develop kidney failure approximately seven years younger than white Americans (57 vs. 64 years of age).
• Diabetes, the number one cause of kidney disease, is more prevalent in African Americans with 18.2 percent compared to 11.2 percent for white Americans aged 40 to 74.
• National surveys suggest that over the past 35 years, the occurrence of diabetes has doubled in African Americans.
• One-third of the African Americans with diabetes are unaware they have the disease.
• African Americans make up 34 percent of newly diagnosed high blood pressure cases each year. High blood pressure is the second leading cause of kidney disease.
• Approximately one in every three African Americans has high blood pressure.
• In the 25- to 44-year-old age group, the rate of African Americans old who get kidney failure caused by high blood pressure is 20 times higher than white Americans.
• Some research indicates that African Americans may have a particular gene that makes them more sensitive to salt, which may be a factor in the increased occurrence of high blood pressure.
• Many African Americans may be unaware of the connection between high blood pressure and chronic kidney disease. Reports indicate that about 43 percent of African Americans who are on dialysis were not aware they had kidney failure until about one week before starting dialysis.

Risk Factors for Diabetes

Type-2 diabetes is the most common type of diabetes in African Americans. Risk factors for type-2 diabetes include:

• family history
• impaired glucose tolerance
• diabetes during pregnancy
• hyperinsulinemia and insulin resistance
• obesity
• lack of physical activity

Symptoms of Diabetes

Below are some common symptoms, however, you can feel fine and still have diabetes, so get checked regularly.

• thirst
• increased urination
• hunger
• unintended weight loss
• fatigue

Prevention of Diabetes & High Blood Pressure

You can take actions to help prevent these diseases by :

• eating a low-fat, low-salt diet
• exercising regularly
• limiting alcohol consumption
• stopping or not starting smoking

If you are already diagnosed with diabetes and/or high blood pressure, in addition to following the above steps, you should also make sure to take your prescribed medication and visit your physician regularly.

Risk Factors for High Blood Pressure

High blood pressure is the second most common cause of kidney failure in African Americans. Risk factors for high blood pressure include:

• aging
• family history of heart disease
• smoking
• being overweight
• using birth control pills
• using too much salt

Symptoms of High Blood Pressure

• there are no symptoms, that's why you should get your blood pressure checked regularly

Risk Factors for Kidney Disease

• diabetes
• high blood pressure
• family member with kidney disease

Symptoms of Kidney Disease

• swelling, especially around the eyes or ankles
• pain in the lower back
• burning or unusual sensation during urination
• bloody or coffee-colored urine
• urinating more often, especially at night
• feeling tired
• high blood pressure
• you can feel fine and still have kidney disease, so get checked regularly

How African Americans Can Better the Odds

• be aware of risk factors for diabetes, high blood pressure and kidney disease
• visit your doctor or a clinic regularly to check: blood sugar, blood pressure, urine protein and kidney function
• to limit the risk of getting diabetes and high blood pressure: eat a healthy diet, limit salt intake, watch your weigh and exercise regularly
• if you're diagnosed with diabetes, high blood pressure or kidney disease: control diabetes and high blood pressure to avoid complications

If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a kidney doctor tool to locate a nephrologist in your area.

Sources:

1. U.S. Renal Data System 2002 Annual Data Report ( www.usrds.org )
2. "Diabetes in African Americans," from the National Kidney and Urologic Diseases Information
3. Clearinghouse ( www.niddk.nih.gov )
4. American Heart Association Meeting Report ( www.americanheart.org )
5. "Early Identification of Renal Disease Among African Americans: A Continuing Problem," M Thornhill
6. Joynes and M. Moore, Nephrology News & Issues, November 1995, p.16-18.
7. Agodoa LY, Appel L, Bakris GL, Beck G, Bourgoignie J, Briggs JP et al. Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis: a randomized controlled trial. JAMA. 2001; 285(21):2719-2728.