Chronic Kidney Disease in African Americans

by Charles Modlin, MD, MBA

Chronic kidney disease (CKD) affects more than an estimated 37 million Americans, which is approximately 15 percent of U.S. adults. That represents one in seven U.S. adults. The risk is even greater for Americans with diabetes or high blood pressure, which represent the two most common causes of kidney disease. As many as nine in ten adults with CKD do not know they have it.

Approximately 80 million U.S. adults are at risk for developing kidney disease, that’s one in three adults in the U.S. Kidney disease is more common in women (14 percent) than men (12 percent). However, for every two women who develop endstage kidney disease (ESKD), three men's kidneys fail.

What is the rate of Kidney Disease and Kidney Failure in the Black population?

African Americans are almost four times as likely as Whites to develop kidney failure. While African Americans make up about 13 percent of the population, they account for 35 percent of the people with kidney failure in the United States.

What are the stages of Chronic Kidney Disease?

What is the role of the kidneys?

The main job of the kidneys is to cleanse the blood of toxins and transform the waste into urine. The kidneys also contribute to the formation of the hormone erythropoietin which aids in the production of the bodies red blood cells. In addition, the kidneys help in the production of Vitamin D which serves to absorb calcium to strengthen the bodies bones and calcium is vital to the function of the heart and vascular system, the muscles and vital to the bodies’ metabolism and many of the bodies cellular functions.

There are five stages of chronic kidney disease. These stages are determined by blood test measurements of the serum creatinine and a formula calculation to determine the Glomerular Filtration Rate (GFR). Generally, when a patient’s GFR falls below 10 (and sometimes 15) the patient is required to start dialysis, which is called renal replacement therapy.

The five stages of Chronic Kidney Disease

• Stage 1 with normal or high GFR (GFR > 90 mL/min)

• Stage 2 Mild CKD (GFR = 60-89 mL/min)

• Stage 3A Moderate CKD (GFR = 45-59 mL/min)

• Stage 3B Moderate CKD (GFR = 30-44 mL/min)

• Stage 4 Severe CKD (GFR = 15-29 mL/min)

• Stage 5 End Stage CKD (GFR <15 mL/min)

What are the early signs and symptoms of Kidney Disease?

In general, there are no signs or symptoms of early kidney disease, thus underscoring the importance of routine physical examinations. These include urinalysis and blood serum creatinine level determinations and monitoring of one’s blood pressure.

What are the symptoms of Chronic Kidney Disease?

Some common signs/symptoms of chronic kidney disease include, but are not limited to the following:

• Feeling more tired

• Low blood count (Anemia)

• Dry, itchy skin

• Muscle cramps

• Brittle bones or bone fractures

• Difficulty sleeping

• Difficulty concentrating

• Change in urination frequency

• Swollen or puffy eye lids and around the eyes, feet, and ankles

• Loss of appetite

• Nausea and vomiting

What are some of the risk factors of Chronic Kidney Disease?

Uncontrolled high blood pressure, poorly controlled diabetes, hyperlipidemia, peripheral vascular disease, heart failure and obesity are the leading risk factors for kidney disease. There are some hereditary conditions, such as adult polycystic kidney disease, that occur in families and predispose some people to developing CKD or kidney failure.

How can you reduce your risk of developing Kidney Disease?

Controlling the above risk factors for kidney disease will help individuals reduce their chances of developing it.

What are risks of Chronic Kidney Disease if left untreated?

In many situations, untreated CKD leads to kidney failure, also called end-stage kidney disease (ESRD).

How do you treat Chronic Kidney Disease?

The treatment of CKD varies according to the stage of the CKD. Interventions for patients with early stage CKD are focused on controlling one’s high blood pressure and diabetes if they have diabetes. Maintaining an ideal body weight is also of paramount importance. In late stages of CKD, the same measures are taken, including taking measures to manage anemia; however, in late stages of CKD, in the appropriate candidates, serious consideration for a kidney transplant is indicated.

Charles Modlin, MD, MBA is a kidney transplant surgeon, urologist, Black Professional of the Year (2015) and the Medical Director of the Office of Inclusion, Diversity & Equity at The MetroHealth System.

Maple Heights

Richmond Heights