Chronic Renal Disease, Second Edition - Chapter 9 - Ethnicity and Chronic Kidney Disease in Disadvantaged Populations - An International Perspective

Ethnicity is a powerful element that affects the incidence, prevalence, and course of chronic kidney disease (CKD) worldwide. Complex interactions of genetic, biologic, cultural, environmental, and socioeconomic factors are associated with CKD differences among countries, including several disadvantaged communities and ethnic minorities in developed countries. Conditions that predispose to CKD such as hypertension, diabetes mellitus, or obesity can be more prevalent in these communities, caused by differences in predisposing genetic backgrounds, prenatal and perinatal care, and experiences, including low birth weights, inadequate diets, infectious diseases, or exposure to toxins. End-stage renal disease incidence tends to rise in communities with social deprivation, and provision of renal replacement therapy depends mostly on extent of national health care expenditures and economic strength. Strategies to provide renal care for all including preventive care, early referral, timely dialysis initiation, and equalizing opportunities for kidney transplantation can be achieved through a concerted effort between nephrologists, governments, patients, charitable organizations, and industry.