Black Americans and Chronic Kidney Disease

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)  states that African Americans are at high risk for developing kidney failure1 . This risk is due in part to high rates of diabetes and high blood pressure in these communities. Below is more information about renal (kidney) failure for Black Americans.

What’s kidney failure?

Kidney failure When your kidneys stop working waste can no longer be removed from your blood, meaning you have kidney failure. Kidney failure is also called end-stage renal disease (ESRD) or Stage 5 CKD. (Renal is a medical term for kidney, meaning “having to do with the kidneys.”) When you have ESRD, you need dialysis or a kidney transplant to survive.

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Black Americans and Kidney Failure

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 32 percent of the people with kidney failure in the United States. Diabetes and high blood pressure are the leading causes of kidney failure among African Americans.

About 1 in 10 people have some degree of chronic kidney disease2 (CKD). It can develop at any age, and various conditions can lead to CKD. However, CKD becomes more common with increasing age. After the age of 40, kidney filtration begins to fall by approximately 1% per year. In addition to the natural aging of the kidneys, many conditions that damage the kidneys are more common in older people including diabetes, high blood pressure, and heart disease.

Your kidneys are Essential

Your kidneys aren’t very large—each is just the size of a computer mouse—but they’re hard-working. They filter all the blood in your body every 30 minutes, removing wastes, toxins, and excess fluid. They also help control blood pressure, stimulate the production of red blood cells, keep your bones healthy, and regulate blood chemicals that are essential to life.

Each kidney is made up of millions of tiny filters called nephrons. Over time, nephrons can become damaged by diabetes, high blood pressure, or other causes and stop working, a condition called chronic kidney disease. or CKD. Healthy nephrons can make up the difference for a while, but if not treated, CKD usually gets worse. CKD can lead to kidney failure, also known as end-stage renal disease (ESRD) or Stage 5 CKD. A person with ESRD will need regular dialysis (a treatment that filters the blood) or a kidney transplant to survive.

Black Americans and Chronic Kidney Disease

Kidney diseases are the 9th leading cause of death in the United States.

Snapshot: Kidney Disease3

  1. Kidney diseases are the 9th leading cause of death in the United States.
  2. Early CKD has no signs or symptoms.
  3. Specific blood and urine tests are needed to check for CKD.
  4. CKD tends to get worse over time.
  5. CKD can be treated (the earlier treatment starts, the better).
  6. CKD can progress to kidney failure.
  7. In 2011, diabetes or hypertension was listed as the primary cause for 7 of 10 new cases of ESRD in the United States.
  8. In 2011, 113,136 patients in the United States started treatment for ESRD
  9. ESRD is more common among adults over 70 years of age.
  10. African Americans are about three and a half times more likely to develop ESRD than whites.

March: Kidney Awareness Around the World

World Kidney Day (March 9) raises awareness about kidney health and promotes kidney disease prevention. This year’s theme—Kidney Disease & Obesity—brings global attention to the direct impact of obesity on developing CKD. Obesity also increases the risk for diabetes and hypertension (high blood pressure), which in turn are risk factors for CKD.

March is also National Kidney Month. During this month and all year long, remember to take care of your hard-working kidneys, and they’ll help take care of you.

Could This Be You?

Approximately 15% of US adults are estimated to have CKD, but because early CKD has no signs or symptoms, most don’t know they have it. If you have any of these risk factors for CKD, talk to your doctor about getting tested:

  • Family history of CKD
  • Diabetes
  • High blood pressure
    Black Americans and Chronic Kidney Disease

    Black Americans account for 32 percent of the people with kidney failure in the U.S.

Your Mileage May Vary

High blood pressure and diabetes are the leading causes of CKD. Approximately 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure could have CKD. Also, the number of young people with type 2 diabetes is increasing; having diabetes for a longer time means more time to develop diabetes complications, including CKD.

Diabetes is the most common cause of end-stage renal disease ( ESRD), accounting for nearly 44% of new cases. African-Americans are about 3 times more likely to develop ESRD than whites. Hispanics are 35% more likely to develop ESRD than non-Hispanics. And there’s a gender gap: Men are nearly 65% more likely than women to progress to ESRD.

Find it Early, Treat it Early

If you’re at risk for kidney disease, get your kidneys checked regularly, which is done by your doctor with simple blood and urine tests. Regular testing is your best chance for identifying CKD early if you do develop it. Early treatment is most effective and can help prevent additional health problems.

Your treatment and management plan may include taking medications and making lifestyle changes—including choosing healthy foods and getting physically active—as well as working to keep your blood sugar and blood pressure numbers as close to target as you can.

Black Americans and Chronic Kidney Disease

Men are nearly 65% more likely than women to progress to ESRD.

Getting a checkup? Make sure to get your kidneys checked, too.

Kidney-Friendly Tips

  • Keep your blood pressure below 140/90 mm Hg (or the target your doctor establishes for you).
  • If you have diabetes, stay in your target blood sugar range as much as possible.
  • Get active—physical activity helps control blood pressure and blood sugar levels.
  • Lose weight if you’re overweight.
  • Get tested for CKD regularly if you’re at risk.
  • If you have CKD, meet with a dietitian to create a kidney-healthy eating plan. The plan may need to change as you get older or if your health status changes.
  • Take medications as instructed, and ask your doctor about blood pressure medicines called ACE inhibitors and ARBs, which may protect your kidneys in addition to lowering blood pressure.
  • If you smoke, quit. Smoking can worsen kidney disease and interfere with medication that lowers blood pressure.
  • Include a kidney doctor (nephrologist) on your health care team.

Prediabetes and CKD Prevention

With prediabetes, blood sugar levels are higher than normal, but not high enough yet to be diagnosed with diabetes. Prediabetes puts people at increased risk of developing type 2 diabetes, heart disease, and stroke. If you have prediabetes, preventing or delaying type 2 diabetes can also help to avoid kidney disease. Visit to find out your prediabetes risk. The website features a short quiz, lifestyle tips, and links to prevention programs across the country that are recognized by CDC as part of the National Diabetes Prevention Program.

Tracking CKD

CKD has an enormous impact on health, quality of life, and healthcare costs and is a national public health priority. The CKD Surveillance System documents and monitors CKD and its risk factors in the United States and tracks progress in CKD prevention, detection, and management.

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