Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Influence of race, ethnicity and socioeconomic status on kidney disease

Nature Reviews Nephrology volume 8, pages 533–541 (2012)Cite this article

Subjects

Abstract

Low socioeconomic status (SES) influences disease incidence and contributes to poor health outcomes throughout an individual's life course across a wide range of populations. Low SES is associated with increased incidence of chronic kidney disease, progression to end-stage renal disease, inadequate dialysis treatment, reduced access to kidney transplantation, and poor health outcomes. Similarly, racial and ethnic disparities, which in the USA are strongly associated with lower SES, are independently associated with poor health outcomes. In this Review, we discuss individual-level and group-level SES factors, and the concomitant role of race and ethnicity that are associated with and mediate the development of chronic kidney disease, progression to end-stage renal disease and access to treatment.

Key Points

  • Socioeconomic status (SES) contributes to the variability in incidence, prevalence and treatment of chronic kidney disease and end-stage renal disease

  • The interplay between race and SES is complex, and efforts to understand health disparities in patients with kidney disease must account for these effects

  • The mechanisms linking poverty to kidney disease outcomes are multifactorial and multilevel, where contextual-level SES factors in addition to individual-level SES factors contribute to kidney disease outcomes

  • The mechanisms by which SES influences the development of risk factors for chronic kidney disease throughout the course of an individual's life are not entirely clear

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Multilevel framework of health disparities in patients with kidney disease.

Similar content being viewed by others

References

  1. Grassmann, A., Gioberge, S., Moeller, S. & Brown, G. ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrol. Dial. Transplant. 20, 2587–2593 (2005).

    Article  PubMed  Google Scholar 

  2. US Renal Data System. US Renal Data System 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States [online], (2010).

  3. Castro, A. F. & Coresh, J. CKD surveillance using laboratory data from the population-based National Health and Nutrition Examination Survey (NHANES). Am. J. Kidney Dis. 53 (Suppl. 3), S46–S55 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Coresh, J. et al. Prevalence of chronic kidney disease in the United States. JAMA 298, 2038–2047 (2007).

    CAS  PubMed  Google Scholar 

  5. US Department of Health and Human Services. National Healthcare Quality Report [online], (2010).

  6. McClellan, W. M. et al. Poverty and racial disparities in kidney disease: the REGARDS study. Am. J. Nephrol. 32, 38–46 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Volkova, N. et al. Neighborhood poverty and racial differences in ESRD incidence. J. Am. Soc. Nephrol. 19, 356–364 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  8. McClellan, W. M. et al. Geographic concentration of poverty and arteriovenous fistula use among ESRD patients. J. Am. Soc. Nephrol. 21, 1776–1782 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Powe, N. R. Let's get serious about racial and ethnic disparities. J. Am. Soc. Nephrol. 19, 1271–1275 (2008).

    Article  PubMed  Google Scholar 

  10. Norris, K. & Nissenson, A. R. Race, gender, and socioeconomic disparities in CKD in the United States. J. Am. Soc. Nephrol. 19, 1261–1270 (2008).

    Article  PubMed  Google Scholar 

  11. Young, B. A. The interaction of race, poverty, and CKD. Am. J. Kidney Dis. 55, 977–980 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  12. Minnick, M. L., Boynton, S., Ndirangu, J. & Furth, S. Sex, race, and socioeconomic disparities in kidney disease in children. Semin. Nephrol. 30, 26–32 (2010).

    Article  PubMed  Google Scholar 

  13. Patzer, R. E. et al. Racial disparities in pediatric access to kidney transplantation: does socioeconomic status play a role? Am. J. Transplant. 12, 369–378 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Oakes, J. M. & Rossi, P. H. The measurement of SES in health research: current practice and steps toward a new approach. Soc. Sci. Med. 56, 769–784 (2003).

    Article  PubMed  Google Scholar 

  15. Galobardes, B., Shaw, M., Lawlor, D. A., Davey Smith, G. & Lynch, J. in Methods in Social Epidemiology 1st edn (eds Oakes, J. M. & Kaufman, J. S.) 47–85 (Jossey-Bass, San Francisco, 2006).

    Google Scholar 

  16. Winker, M. A. Measuring race and ethnicity: why and how? JAMA 292, 1612–1614 (2004).

    Article  CAS  PubMed  Google Scholar 

  17. Tareen, N. et al. Chronic kidney disease in African American and Mexican American populations. Kidney Int. Suppl. 97, S137–S140 (2005).

    Article  Google Scholar 

  18. Block, J. P., Scribner, R. A. & DeSalvo, K. B. Fast food, race/ethnicity, and income: a geographic analysis. Am. J. Prev. Med. 27, 211–217 (2004).

    PubMed  Google Scholar 

  19. Blakely, T. A. & Woodward, A. J. Ecological effects in multi-level studies. J. Epidemiol. Commun. Health 54, 367–374 (2000).

    Article  CAS  Google Scholar 

  20. Diez Roux, A. V. Next steps in understanding the multilevel determinants of health. J. Epidemiol. Commun. Health 62, 957–959 (2008).

    Article  CAS  Google Scholar 

  21. Diez-Roux, A. V. Bringing context back into epidemiology: variables and fallacies in multilevel analysis. Am. J. Public Health 88, 216–222 (1998).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Ward, M. M. Access to care and the incidence of end-stage renal disease due to diabetes. Diabetes Care 32, 1032–1036 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kershaw, K. N. et al. Metropolitan-level racial residential segregation and black-white disparities in hypertension. Am. J. Epidemiol. 174, 537–545 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  24. Prakash, S. et al. Racial composition of residential areas associates with access to pre-ESRD nephrology care. J. Am. Soc. Nephrol. 21, 1192–1199 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  25. Rodriguez, R. A. et al. Geography matters: relationships among urban residential segregation, dialysis facilities, and patient outcomes. Ann. Intern. Med. 146, 493–501 (2007).

    Article  PubMed  Google Scholar 

  26. Crews, D. C., Charles, R. F., Evans, M. K., Zonderman, A. B. & Powe, N. R. Poverty, race, and CKD in a racially and socioeconomically diverse urban population. Am. J. Kidney Dis. 55, 992–1000 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  27. Hall, Y. N., Choi, A. I., Chertow, G. M. & Bindman, A. B. Chronic kidney disease in the urban poor. Clin. J. Am. Soc. Nephrol. 5, 828–835 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  28. Diez Roux, A. V. Investigating neighborhood and area effects on health. Am. J. Public Health 91, 1783–1789 (2001).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Friedman, D. J. & Pollak, M. R. Genetics of kidney failure and the evolving story of APOL1. J. Clin. Investig. 121, 3367–3374 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. McClellan, W. M. et al. Association of family history of ESRD, prevalent albuminuria, and reduced GFR with incident ESRD. Am. J. Kidney Dis. 59, 25–31 (2012).

    Article  PubMed  Google Scholar 

  31. Luyckx, V. A. & Brenner, B. M. The clinical importance of nephron mass. J. Am. Soc. Nephrol. 21, 898–910 (2010).

    Article  PubMed  Google Scholar 

  32. Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C. & Braveman, P. A. Socioeconomic disparities in adverse birth outcomes: a systematic review. Am. J. Prev. Med. 39, 263–272 (2010).

    Article  PubMed  Google Scholar 

  33. Sellström, E. & Bremberg, S. The significance of neighbourhood context to child and adolescent health and well-being: a systematic review of multilevel studies. Scand. J. Public Health 34, 544–554 (2006).

    Article  PubMed  Google Scholar 

  34. White, S. L. et al. Is low birth weight an antecedent of CKD in later life? A systematic review of observational studies. Am. J. Kidney Dis. 54, 248–261 (2009).

    Article  PubMed  Google Scholar 

  35. Orskov, B., Christensen, K. B., Feldt-Rasmussen, B. & Strandgaard, S. Low birth weight is associated with earlier onset of end-stage renal disease in Danish patients with autosomal dominant polycystic kidney disease. Kidney Int. 81, 919–924 (2012).

    Article  CAS  PubMed  Google Scholar 

  36. Rajan, T., Barbour, S. J., White, C. T. & Levin, A. Low birth weight and nephron mass and their role in the progression of chronic kidney disease: a case report on identical twins with Alport disease. Nephrol. Dial. Transplant. 26, 4136–4139 (2011).

    Article  PubMed  Google Scholar 

  37. Nistala, R. et al. Prenatal programming and epigenetics in the genesis of the cardiorenal syndrome. Cardiorenal Med. 1, 243–254 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Silverman, J. G., Decker, M. R., Reed, E. & Raj, A. Intimate partner violence victimization prior to and during pregnancy among women residing in 26 U.S. states: associations with maternal and neonatal health. Am. J. Obstet. Gynecol. 195, 140–148 (2006).

    Article  PubMed  Google Scholar 

  39. Berenson, G. S. et al. Creatinine clearance, electrolytes, and plasma renin activity related to the blood pressure of white and black children—the Bogalusa Heart Study. J. Lab. Clin. Med. 93, 535–548 (1979).

    CAS  PubMed  Google Scholar 

  40. Cruickshank, J. K. et al. Origins of the “black/white” difference in blood pressure: roles of birth weight, postnatal growth, early blood pressure, and adolescent body size: the Bogalusa Heart study. Circulation 111, 1932–1937 (2005).

    Article  CAS  PubMed  Google Scholar 

  41. Chen, W., Srinivasan, S. R., Ruan, L., Mei, H. & Berenson, G. S. Adult hypertension is associated with blood pressure variability in childhood in blacks and whites: the Bogalusa Heart Study. Am. J. Hypertens. 24, 77–82 (2011).

    Article  PubMed  Google Scholar 

  42. Deshmukh-Taskar, P. et al. Tracking of overweight status from childhood to young adulthood: the Bogalusa Heart Study. Eur. J. Clin. Nutr. 60, 48–57 (2006).

    Article  CAS  PubMed  Google Scholar 

  43. Chen, W., Srinivasan, S. R. & Berenson, G. S. Amplification of the association between birthweight and blood pressure with age: the Bogalusa Heart Study. J. Hypertens. 28, 2046–2052 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Muntner, P. et al. End-stage renal disease in young black males in a black-white population: longitudinal analysis of the Bogalusa Heart Study. BMC Nephrol. 10, 40 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  45. Ludwig, J. et al. Neighborhoods, obesity, and diabetes—a randomized social experiment. N. Engl. J. Med. 365, 1509–1519 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Langenberg, C. et al. Social circumstances and education: life course origins of social inequalities in metabolic risk in a prospective national birth cohort. Am. J. Public Health 96, 2216–2221 (2006).

    Article  PubMed  PubMed Central  Google Scholar 

  47. Wills, A. K. et al. Life course trajectories of systolic blood pressure using longitudinal data from eight UK cohorts. PLoS Med. 8, e1000440 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  48. Shoham, D. A., Vupputuri, S. & Kshirsagar, A. V. Chronic kidney disease and life course socioeconomic status: a review. Adv. Chronic Kidney Dis. 12, 56–63 (2005).

    Article  PubMed  Google Scholar 

  49. Bowman, S. Low economic status is associated with suboptimal intakes of nutritious foods by adults in the National Health and Nutrition Examination Survey 1999–2002. Nutr. Res. 27, 515–523 (2007).

    Article  CAS  Google Scholar 

  50. Raffensperger, S. et al. Effect of race and predictors of socioeconomic status on diet quality in the HANDLS Study sample. J. Natl Med. Assoc. 102, 923–930 (2010).

    Article  PubMed  Google Scholar 

  51. Fouque, D. & Laville, M. Low protein diets for chronic kidney disease in non diabetic adults. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD001892. http://dx.doi.org/10.1002/14651858.CD001892.pub3.

  52. Jones-Burton, C. et al. An in-depth review of the evidence linking dietary salt intake and progression of chronic kidney disease. Am. J. Nephrol. 26, 268–275 (2006).

    Article  CAS  PubMed  Google Scholar 

  53. Gutiérrez, O. M. et al. Low socioeconomic status associates with higher serum phosphate irrespective of race. J. Am. Soc. Nephrol. 21, 1953–1960 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Boone-Heinonen, J. et al. Fast food restaurants and food stores: longitudinal associations with diet in young to middle-aged adults: the CARDIA study. Arch. Intern. Med. 171, 1162–1170 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  55. Egan, B. M., Zhao, Y. & Axon, R. N. US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA 303, 2043–2050 (2010).

    Article  CAS  PubMed  Google Scholar 

  56. Kershaw, K. N. et al. Metropolitan-level racial residential segregation and black-white disparities in hypertension. Am. J. Epidemiol. 174, 537–545 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  57. Egede, L. E. et al. Regional, geographic, and racial/ethnic variation in glycemic control in a national sample of veterans with diabetes. Diabetes Care 34, 938–943 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  58. Ejerblad, E. et al. Obesity and risk for chronic renal failure. J. Am. Soc. Nephrol. 17, 1695–1702 (2006).

    Article  CAS  PubMed  Google Scholar 

  59. Kalaitzidis, R. G. & Siamopoulos, K. C. The role of obesity in kidney disease: recent findings and potential mechanisms. Int. Urol. Nephrol. 43, 771–784 (2011).

    Article  PubMed  Google Scholar 

  60. Afshinnia, F., Wilt, T. J., Duval, S., Esmaeili, A. & Ibrahim, H. N. Weight loss and proteinuria: systematic review of clinical trials and comparative cohorts. Nephrol. Dial. Transplant. 25, 1173–1183 (2010).

    Article  PubMed  Google Scholar 

  61. Murasko, J. E. Trends in the associations between family income, height and body mass index in US children and adolescents: 1971–1980 and 1999–2008. Ann. Hum. Biol. 38, 290–306 (2011).

    Article  PubMed  Google Scholar 

  62. Choi, A. I. et al. Association of educational attainment with chronic disease and mortality: the Kidney Early Evaluation Program (KEEP). Am. J. Kidney Dis. 58, 228–234 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  63. Green, J. A. et al. Prevalence and demographic and clinical associations of health literacy in patients on maintenance hemodialysis. Clin. J. Am. Soc. Nephrol. 6, 1354–1360 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  64. Grubbs, V., Gregorich, S. E., Perez-Stable, E. J. & Hsu, C. Y. Health literacy and access to kidney transplantation. Clin. J. Am. Soc. Nephrol. 4, 195–200 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  65. Cavanaugh, K. L. et al. Low health literacy associates with increased mortality in ESRD. J. Am. Soc. Nephrol. 21, 1979–1985 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Greer, R. C., Cooper, L. A., Crews, D. C., Powe, N. R. & Boulware, L. E. Quality of patient-physician discussions about CKD in primary care: a cross-sectional study. Am. J. Kidney Dis. 57, 583–591 (2011).

    Article  PubMed  Google Scholar 

  67. Waterman, A. D., Browne, T., Waterman, B. M., Gladstone, E. H. & Hostetter, T. Attitudes and behaviors of African Americans regarding early detection of kidney disease. Am. J. Kidney Dis. 51, 554–562 (2008).

    Article  PubMed  Google Scholar 

  68. Jurkovitz, C., Hylton, T. N. & McClellan, W. M. Pathogenesis and treatment of kidney disease and hypertension prevalence of family history of kidney disease and perception of risk for kidney disease: a population-based study. Am. J. Kidney Dis. 46, 11–17 (2005).

    Article  PubMed  Google Scholar 

  69. Boulware, L. E., Carson, K. A., Troll, M. U., Powe, N. R. & Cooper, L. A. Perceived susceptibility to chronic kidney disease among high-risk patients seen in primary care practices. J. Gen. Intern. Med. 24, 1123–1129 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  70. Plantinga, L. C., Tuot, D. S. & Powe, N. R. Awareness of chronic kidney disease among patients and providers. Adv. Chronic Kidney Dis. 17, 225–236 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  71. Tuot, D. S. et al. Chronic kidney disease awareness among individuals with clinical markers of kidney dysfunction. Clin. J. Am. Soc. Nephrol. 6, 1838–1844 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  72. Gaskin, D. J. et al. Examining racial and ethnic disparities in site of usual source of care. J. Natl Med. Assoc. 99, 22–30 (2007).

    PubMed  PubMed Central  Google Scholar 

  73. Evans, K. et al. Race differences in access to health care and disparities in incident chronic kidney disease in the US. Nephrol. Dial. Transplant. 26, 899–908 (2011).

    Article  PubMed  Google Scholar 

  74. Guessous, I., McClellan, W., Vupputuri, S. & Wasse, H. Low documentation of chronic kidney disease among high-risk patients in a managed care population: a retrospective cohort study. BMC Nephrol. 10, 25 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Allen, A. S. et al. Primary care management of chronic kidney disease. J. Gen. Intern. Med. 26, 386–392 (2011).

    Article  PubMed  Google Scholar 

  76. Fox, C. H., Brooks, A., Zayas, L. E., McClellan, W. & Murray, B. Primary care physicians' knowledge and practice patterns in the treatment of chronic kidney disease: an Upstate New York Practice-based Research Network (UNYNET) study. J. Am. Board Fam. Med. 19, 54–61 (2006).

    Article  PubMed  Google Scholar 

  77. Agrawal, V., Agarwal, M., Ghosh, A. K., Barnes, M. A. & McCullough, P. A. Identification and management of chronic kidney disease complications by internal medicine residents: a national survey. Am. J. Ther. 18, e40–e47 (2011).

    Article  PubMed  Google Scholar 

  78. Finkelstein, F. O. et al. Perceived knowledge among patients cared for by nephrologists about chronic kidney disease and end-stage renal disease therapies. Kidney Int. 74, 1178–1184 (2008).

    Article  PubMed  Google Scholar 

  79. Flessner, M. F. et al. Prevalence and awareness of CKD among African Americans: the Jackson Heart Study. Am. J. Kidney Dis. 53, 238–247 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  80. Owen, W. F. Jr, Chertow, G. M., Lazarus, J. M. & Lowrie, E. G. Dose of hemodialysis and survival: differences by race and sex. JAMA 280, 1764–1768 (1998).

    Article  PubMed  Google Scholar 

  81. Leonard, M. B., Stablein, D. M., Ho, M., Jabs, K. & Feldman, H. I. Racial and center differences in hemodialysis adequacy in children treated at pediatric centers: a North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) report. J. Am. Soc. Nephrol. 15, 2923–2932 (2004).

    Article  PubMed  Google Scholar 

  82. Wasse, H., Hopson, S. D. & McClellan, W. Racial and gender differences in arteriovenous fistula use among incident hemodialysis patients. Am. J. Nephrol. 32, 234–241 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  83. Hall, Y. N., Choi, A. I., Xu, P., O'Hare, A. M. & Chertow, G. M. Racial ethnic differences in rates and determinants of deceased donor kidney transplantation. J. Am. Soc Nephrol. 22, 743–751 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  84. Ayanian, J. Z., Cleary, P. D., Weissman, J. S. & Epstein, A. M. The effect of patients' preferences on racial differences in access to renal transplantation. N. Engl. J. Med. 341, 1661–1669 (1999).

    Article  CAS  PubMed  Google Scholar 

  85. Alexander, G. C. & Sehgal, A. R. Barriers to cadaveric renal transplantation among blacks, women, and the poor. JAMA 280, 1148–1152 (1998).

    Article  CAS  PubMed  Google Scholar 

  86. Garg, P. P., Frick, K. D., Diener-West, M. & Powe, N. R. Effect of the ownership of dialysis facilities on patients' survival and referral for transplantation. N. Engl. J. Med. 341, 1653–1660 (1999).

    Article  CAS  PubMed  Google Scholar 

  87. Patzer, R. E. et al. The role of race and poverty on steps to kidney transplantation in the southeastern United States. Am. J. Transplant. 12, 358–368 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. Weng, F. L., Joffe, M. M., Feldman, H. I. & Mange, K. C. Rates of completion of the medical evaluation for renal transplantation. Am. J. Kidney Dis. 46, 734–745 (2005).

    Article  PubMed  Google Scholar 

  89. Patzer, R. E. et al. Neighborhood poverty and racial disparities in kidney transplant waitlisting. J. Am. Soc. Nephrol. 20, 1333–1340 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  90. Saunders, M. R., Cagney, K. A., Ross, L. F. & Alexander, G. C. Neighborhood poverty, racial composition and renal transplant waitlist. Am. J. Transplant. 10, 1912–1917 (2010).

    Article  CAS  PubMed  Google Scholar 

  91. Ashby, V. B. et al. Geographic variability in access to primary kidney transplantation in the United States, 1996–2005. Am. J. Transplant. 7, 1412–1423 (2007).

    Article  CAS  PubMed  Google Scholar 

  92. Stolzmann, K. L. et al. Trends in kidney transplantation rates and disparities. J. Natl Med. Assoc. 99, 923–932 (2007).

    PubMed  PubMed Central  Google Scholar 

  93. Waterman, A. D., Rodrigue, J. R., Purnell, T. S., Ladin, K. & Boulware, L. E. Addressing racial and ethnic disparities in live donor kidney transplantation: priorities for research and intervention. Semin. Nephrol. 30, 90–98 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  94. Weng, F. L., Reese, P. P., Mulgaonkar, S. & Patel, A. M. Barriers to living donor kidney transplantation among black or older transplant candidates. Clin. J. Am. Soc. Nephrol. 5, 2338–2347 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  95. Powe, N. R. To have and have not: health and health care disparities in chronic kidney disease. Kidney Int. 64, 763–772 (2003).

    Article  PubMed  Google Scholar 

  96. Wolfe, R. A. et al. Differences in access to cadaveric renal transplantation in the United States. Am. J. Kidney Dis. 36, 1025–1033 (2000).

    Article  CAS  PubMed  Google Scholar 

  97. Navaneethan, S. D. & Singh, S. A systematic review of barriers in access to renal transplantation among African Americans in the United States. Clin. Transplant. 20, 769–775 (2006).

    Article  PubMed  Google Scholar 

  98. Soucie, J. M., Neylan, J. F. & McClellan, W. Race and sex differences in the identification of candidates for renal transplantation. Am. J. Kidney Dis. 19, 414–419 (1992).

    Article  CAS  PubMed  Google Scholar 

  99. Gaylin, D. S. et al. The impact of comorbid and sociodemographic factors on access to renal transplantation. JAMA 269, 603–608 (1993).

    Article  CAS  PubMed  Google Scholar 

  100. Axelrod, D. A. et al. The interplay of socioeconomic status, distance to center, and interdonor service area travel on kidney transplant access and outcomes. Clin. J. Am. Soc. Nephrol. 5, 2276–2288 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  101. Schold, J. D. et al. Barriers to evaluation and wait listing for kidney transplantation. Clin. J. Am. Soc. Nephrol. 6, 1760–1767 (2011).

    Article  PubMed  Google Scholar 

  102. Keith, D., Ashby, V. B., Port, F. K. & Leichtman, A. B. Insurance type and minority status associated with large disparities in prelisting dialysis among candidates for kidney transplantation. Clin. J. Am. Soc. Nephrol. 3, 463–470 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  103. Neyhart, C. D. Education of patients pre and post-transplant: improving outcomes by overcoming the barriers. Nephrol. Nurs. J. 35, 409–410 (2008).

    PubMed  Google Scholar 

  104. Patzer, R. E. et al. Impact of a patient education program on disparities in kidney transplant evaluation. Clin. J. Am. Soc. Nephrol. 7, 648–655 (2012).

    Article  PubMed  Google Scholar 

  105. Goldfarb-Rumyantzev, A. S. et al. Effect of education on racial disparities in access to kidney transplantation. Clin. Transplant. 26, 74–81 (2010).

    Article  PubMed  Google Scholar 

  106. Reddan, D. N., Szczech, L. A., Klassen, P. S. & Owen, W. F. Jr. Racial inequity in America's ESRD program. Semin. Dial. 13, 399–403 (2000).

    Article  CAS  PubMed  Google Scholar 

  107. Young, C. J. & Gaston, R. S. Renal transplantation in black Americans. N. Engl. J. Med. 343, 1545–1552 (2000).

    Article  CAS  PubMed  Google Scholar 

  108. Kucirka, L. G., Grams, M. E., Balhara, K. S., Jaar, B. G. & Segev, D. L. Disparities in provision of transplant information affect access to kidney transplantation. Am. J. Transplant. 12, 351–357 (2012).

    Article  CAS  PubMed  Google Scholar 

  109. Gordon, E. J. & Sehgal, A. R. Patient-nephrologist discussions about kidney transplantation as a treatment option. Adv. Ren. Replace. Ther. 7, 177–183 (2000).

    Article  CAS  PubMed  Google Scholar 

  110. Pradel, F. G., Jain, R., Mullins, C. D., Vassalotti, J. A. & Bartlett, S. T. A survey of nephrologists' views on preemptive transplantation. Clin. J. Am. Soc. Nephrol. 3, 1837–1845 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  111. Green, J. A. et al. Prevalence and demographic and clinical associations of health literacy in patients on maintenance hemodialysis. Clin. J. Am. Soc. Nephrol. 6, 1354–1360 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  112. Hall, Y. N., O'Hare, A. M., Young, B. A., Boyko, E. J. & Chertow, G. M. Neighborhood poverty and kidney transplantation among US Asians and Pacific Islanders with end-stage renal disease. Am. J. Transplant. 8, 2402–2409 (2008).

    Article  CAS  PubMed  Google Scholar 

  113. Tonelli, M., Klarenbach, S., Rose, C., Wiebe, N. & Gill, J. Access to kidney transplantation among remote- and rural-dwelling patients with kidney failure in the United States. JAMA 301, 1681–1690 (2009).

    Article  CAS  PubMed  Google Scholar 

  114. Lopez, A. D., Mathers, C. D., Ezzati, M., Jamison, D. T. & Murray, C. J. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367, 1747–1757 (2006).

    Article  PubMed  Google Scholar 

  115. Mackenbach, J. P. et al. Socioeconomic inequalities in health in 22 European countries. N. Engl. J. Med. 358, 2468–2481 (2008).

    Article  CAS  PubMed  Google Scholar 

  116. Barker, D. J. The origins of the developmental origins theory. J. Intern. Med. 261, 412–417 (2007).

    Article  CAS  PubMed  Google Scholar 

  117. Nitsch, D. et al. Fetal, developmental, and parental influences on cystatin C in childhood: the Uppsala Family Study. Am. J. Kidney Dis. 57, 863–872 (2011).

    Article  CAS  PubMed  Google Scholar 

  118. Salgado, C. M., Jardim, P. C., Teles, F. B. & Nunes, M. C. Influence of low birth weight on microalbuminuria and blood pressure of school children. Clin. Nephrol. 71, 367–374 (2009).

    Article  CAS  PubMed  Google Scholar 

  119. Laganovic, M. et al. Kidney volume and albuminuria as markers of birth weight-blood pressure relationship in essential hypertension. Kidney Blood Press. Res. 32, 399–404 (2009).

    Article  PubMed  Google Scholar 

  120. Painter, R. C. et al. Microalbuminuria in adults after prenatal exposure to the Dutch famine. J. Am. Soc. Nephrol. 16, 189–194 (2005).

    Article  PubMed  Google Scholar 

  121. Banks, J., Marmot, M., Oldfield, Z. & Smith, J. P. Disease and disadvantage in the United States and in England. JAMA 295, 2037–2045 (2006).

    Article  CAS  PubMed  Google Scholar 

  122. Banks, J. W., Marmot, M., Oldfield, Z. & Smith, J. P. The SES health gradient on both sides of the Atlantic: IZA Discussion Paper No. 2539 [online], (2007).

    Book  Google Scholar 

  123. Al-Qaoud, T. M., Nitsch, D., Wells, J., Witte, D. R. & Brunner, E. J. Socioeconomic status and reduced kidney function in the Whitehall II Study: role of obesity and metabolic syndrome. Am. J. Kidney Dis. 58, 389–397 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  124. Bello, A. K., Peters, J., Rigby, J., Rahman, A. A. & El-Nahas, M. Socioeconomic status and chronic kidney disease at presentation to a renal service in the United Kingdom. Clin. J. Am. Soc. Nephrol. 3, 1316–1323 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  125. Hossain, M. P., Palmer, D., Goyder, E. & El Nahas, A. M. Association of deprivation with worse outcomes in chronic kidney disease: findings from a hospital-based cohort in the United Kingdom. Nephron Clin. Pract. 120, c59–c70 (2012).

    Article  CAS  PubMed  Google Scholar 

  126. Maheswaran, R. et al. Socioeconomic deprivation, travel distance, and renal replacement therapy in the Trent Region, United Kingdom 2000: an ecological study. J. Epidemiol. Commun. Health 57, 523–524 (2003).

    Article  CAS  Google Scholar 

  127. Cass, A., Cunningham, J., Wang, Z. & Hoy, W. Regional variation in the incidence of end-stage renal disease in Indigenous Australians. Med. J. Aust. 175, 24–27 (2001).

    CAS  PubMed  Google Scholar 

  128. Wolf, G., Busch, M., Müller, N. & Müller, U. A. Association between socioeconomic status and renal function in a population of German patients with diabetic nephropathy treated at a tertiary centre. Nephrol. Dial. Transplant. 26, 4017–4023 (2011).

    Article  PubMed  Google Scholar 

  129. Fored, C. M. et al. Socio-economic status and chronic renal failure: a population-based case-control study in Sweden. Nephrol. Dial. Transplant. 18, 82–88 (2003).

    Article  PubMed  Google Scholar 

  130. Hommel, K., Rasmussen, S., Kamper, A. L. & Madsen, M. Regional and social inequalities in chronic renal replacement therapy in Denmark. Nephrol. Dial. Transplant. 25, 2624–2632 (2010).

    Article  PubMed  Google Scholar 

  131. Collins, J. F. Kidney disease in Maori and Pacific people in New Zealand. Clin. Nephrol. 74 (Suppl. 1), S61–S65 (2010).

    PubMed  Google Scholar 

  132. Parameswaran, S. et al. Referral pattern of patients with end-stage renal disease at a public sector hospital and its impact on outcome. Natl Med. J. India 24, 208–213 (2011).

    PubMed  Google Scholar 

  133. Abraham, G. et al. Resource settings have a major influence on the outcome of maintenance hemodialysis patients in South India. Hemodial. Int. 14, 211–217 (2010).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Emory University School of Medicine, Emory Transplant Center, 101 Woodruff Circle, 5125 WMB, Atlanta, 30322, GA, USA

    Rachel E. Patzer

  2. Department of Epidemiology, Emory University, Rollins School of Public Health, 1518 Clifton Avenue N. E., Atlanta, 30312, GA, USA

    William M. McClellan

Authors
  1. Rachel E. Patzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William M. McClellan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

R. E. Patzer and W. M. McClellan contributed equally to discussion of content for the article, researching data to include in the manuscript, writing, reviewing and editing of the manuscript before submission.

Corresponding author

Correspondence to William M. McClellan.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Patzer, R., McClellan, W. Influence of race, ethnicity and socioeconomic status on kidney disease. Nat Rev Nephrol 8, 533–541 (2012). https://doi.org/10.1038/nrneph.2012.117

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2012.117

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing