The epidemiology of end-stage renal disease among African Americans

Am J Med Sci. 2002 Feb;323(2):65-71. doi: 10.1097/00000441-200202000-00002.


Although disparities in outcomes among African Americans compared with whites with respect to cardiovascular disease, cancer, diabetes, infant mortality, and other health standards have been well-described, these disparities are most dramatic with respect to kidney diseases. End-stage renal disease (ESRD) occurs almost 4 times more commonly in African Americans than in their white counterparts. These disparate rates of kidney disease may be caused by the complex interplay of genetic, environmental, cultural, and socioeconomic factors. African Americans are particularly vulnerable to the deleterious renal effects of hypertension and may require more aggressive blood pressure control than whites to accrue benefit with respect to preservation of renal function. Diabetes, the leading cause of ESRD in the United States, is another important factor in the excess renal morbidity and mortality of African Americans because of its prevalence in this population. Other renal diseases, especially those associated with HIV/AIDS, are also much more likely to affect African Americans than other American population subgroups. A more thorough understanding of the epidemiology of renal diseases in African Americans and the cultural, social, and biological differences that underlie racial disparities in prevalence of renal disease will be essential to the design of effective public health strategies for prevention and treatment of this burdensome problem.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • AIDS-Associated Nephropathy / complications
  • AIDS-Associated Nephropathy / ethnology
  • Adolescent
  • Adult
  • African Americans*
  • Age Factors
  • Blacks
  • Child
  • Diabetes Complications
  • Diabetes Mellitus / ethnology
  • Diagnosis, Differential
  • Humans
  • Hypertension / complications
  • Hypertension / ethnology
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / prevention & control