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Curr Opin Nephrol Hypertens. 2014 May;23(3):298-305. doi: 10.1097/01.mnh.0000444822.25991.f6.

Disparities in the burden, outcomes, and care of chronic kidney disease.

Author information

aDivision of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine bWelch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions cDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland dDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.



Racial, ethnic and socioeconomic disparities in chronic kidney disease (CKD) have been documented for decades, yet little progress has been made in mitigating them. Several recent studies offer new insights into the root causes of these disparities, point to areas in which future research is warranted, and identify opportunities for changes in policy and clinical practice.


Recently published evidence suggests that geographic disparities in CKD prevalence exist and vary by race. CKD progression is more rapid for racial and ethnic minority groups compared with whites and may be largely, but not completely, explained by genetic factors. Stark socioeconomic disparities in outcomes for dialysis patients exist and vary by race, place of residence, and treatment facility. Disparities in access to living kidney donation may be driven primarily by the socioeconomic status of the donor as opposed to recipient factors.


Recent studies highlight opportunities to eliminate disparities in CKD, including efforts to direct resources to areas and populations where disparities are most prevalent, efforts to understand how to best use emerging information on the contribution of genetic factors to disparities, and continued work to identify modifiable environmental, social, and behavioral factors for targeted interventions among high-risk populations.

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