Current State and Future Trends to Optimize the Care of African Americans with End-Stage Renal Disease

Kimberly Harding, Tesfaye B. Mersha, Fern J. Webb, Joseph A. Vassalotti, Susanne B. Nicholas

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Background: Chronic kidney disease is a progressive disease, which terminates in end-stage renal diseases (ESRD) that requires either dialysis or kidney transplantation for the patient to survive. There is an alarming trend in the disparities of ESRD in African Americans (AAs). Currently, AAs represent more than 30% of incident ESRD cases, yet they constitute 15% of the overall US population. Despite the reductions in mortality, increases in access to patient-centered home dialysis and preemptive kidney transplantation for the overall US ESRD population over the last decade, disparities in the care of AAs with ESRD remain largely unaffected. Summary: This review discusses patient-, community-, and practitioner-related factors that contribute to disparities in ESRD care for AAs. In particular, the review addresses issues related to end-of-life support, the importance of Apolipoprotein-1 gene variants, and the advent of pharmacogenomics toward achieving precision care. The need for accessible clinical intelligence for the ESRD population is discussed. Several interventions and a call to action to address the disparities are presented. Key Messages: Significant disparities in ESRD care exist for AAs. Strategies to enhance patient engagement, education, accountable partnerships, and clinical intelligence may reduce these disparities.

Original languageEnglish
Pages (from-to)156-164
Number of pages9
JournalAmerican Journal of Nephrology
Volume46
Issue number2
DOIs
StatePublished - 1 Aug 2017

Keywords

  • Accountable partnerships
  • African Americans
  • Call to action
  • Care coordination
  • End of life
  • End-stage renal disease
  • Health disparities
  • Palliative care

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