Premium
Hemodialysis Disparities in African Americans: The Deeply Integrated Concept of Race in the Social Fabric of Our Society
Author(s) -
Norris Keith C.,
Williams Sandra F.,
Rhee Connie M.,
Nicholas Susanne B.,
Kovesdy Csaba P.,
KalantarZadeh Kamyar,
Ebony Boulware L.
Publication year - 2017
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12589
Subject(s) - medicine , end stage renal disease , dialysis , ethnic group , race (biology) , hemodialysis , race and health , health equity , gerontology , disease , social determinants of health , demography , public health , pathology , gender studies , sociology , anthropology
End‐stage renal disease ( ESRD ) is one of the starkest examples of racial/ethnic disparities in health. Racial/ethnic minorities are 1.5 to nearly 4 times more likely than their non‐Hispanic White counterparts to require renal replacement therapy ( RRT ), with African Americans suffering from the highest rates of ESRD . Despite improvements over the last 25 years, substantial racial differences are persistent in dialysis quality measures such as RRT modality options, dialysis adequacy, anemia, mineral and bone disease, vascular access, and pre‐ ESRD care. This report will outline the current status of racial disparities in key ESRD quality measures and explore the impact of race. While the term race represents a social construct, its association with health is more complex. Multiple individual and community level social determinants of health are defined by the social positioning of race in the U.S., while biologic differences may reflect distinct epigenetic changes and linkages to ancestral geographic origins. Together, these factors conspire to influence dialysis outcomes among African Americans with ESRD .