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Semin Nephrol. 2013 Sep;33(5):468-75. doi: 10.1016/j.semnephrol.2013.07.008.

Socioeconomic factors and racial disparities in kidney disease outcomes.

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Division of Nephrology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD. Electronic address:


African Americans suffer disproportionately from advanced and progressive chronic kidney disease (CKD). Socioeconomic factors are believed to play an important role in this disparity, and likely influence African Americans' increased risk of CKD through multiple pathways. Low socioeconomic status (SES) may contribute to racial disparities in CKD because of the greater prevalence of poverty, for example, among African Americans as compared with whites. However, low SES has a stronger relation with CKD among African Americans than among whites, underscoring that the context and magnitude of socioeconomic influences on CKD outcomes varies between these populations. These socioeconomic influences may produce new or potentiate existing racial differences in biology. This review discusses what is known about the role of SES in explaining racial disparities in CKD, highlights several knowledge gaps in this area, and suggests future directions toward the elimination of disparities in CKD.


African Americans; Race; chronic kidney disease; poverty; social determinants; socioeconomic status

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