Blacks Hard Hit by Kidney Disease

Even though they comprise just 12 percent of the U.S. population, blacks make up nearly a third of the 20 million Americans with life-threatening kidney disease.

Even though they comprise just 12 percent of the U.S. population, blacks make up nearly a third of the 20 million Americans with life-threatening kidney disease.And because early detection of kidney disease is crucial to keeping patients healthy, a new federal government campaign is putting the spotlight on American blacks, to identify those at highest risk.”African-American men between ages 20 and 40 have a 20-fold increased risk of kidney failure compared to white men,” explained Dr. Thomas Hostetter, director of the National Kidney Disease Education Program, a project of the U.S. Department of Health & Human Services.”We don’t know entirely why African-Americans, both men and women, are more likely to get kidney failure,” Hostetter added. However, high blood pressure, diabetes or a family history of kidney failure can all work together to raise risks for kidney trouble.”The high [blood] pressure actually damages the small blood vessels in the kidney, causing them to scar down, decrease function and in turn worsen the blood pressure,” Hostetter said.High blood sugar found in diabetics can also be toxic to the kidney, Hostetter added.The kidneys, bean-shaped organs about the size of a fist, are located near the middle of the back, just under the rib cage. They filter blood via tiny units called nephrons, removing waste products and extra water, which is excreted as urine.If the kidneys did not remove these wastes, they would build up in the blood and damage the body.The new government campaign, called “You Have the Power to Prevent Kidney Disease,” encourages those at high risk to get tested regularly.Early detection can minimize the discomfort and medical care needed for those with kidney disease. The number of Americans on kidney dialysis or who have had a kidney transplant due to failure has doubled each decade for the past two decades, according to the National Institutes of Health (NIH).Right now, about half a million people have kidney failure, with that number expected to surpass 660,000 by 2010, according to the NIH.”There are a couple of simple tests,” Hostetter said, including a blood screen called the serum creatinine test, used “to estimate the filtering capacity of the kidney.”Creatinine, a byproduct of muscle metabolism, is found naturally in the body. “If the kidney is normal, it is excreted,” Hostetter said. “If it’s not normal, creatinine builds up. It’s not itself toxic, but is a marker [of toxicity].”Another test recommended for those at risk is one that looks for protein in the urine, which also helps detect early kidney damage, Hostetter said.In addition to testing, there are a number of healthy habits everyone can follow to reduce their kidney disease risk, said Dr. Peter Galier, chief of staff at Santa Monica UCLA Medical Center and an associate professor of medicine at UCLA David Geffen School of Medicine in Los Angeles.Galier advises patients who want to minimize kidney disease risk to first of all “watch your weight.” Keeping obesity at bay helps keep blood pressure under control, too. He also tells patients to exercise and cut down on salt, which can worsen high blood pressure in some.If patients are at especially high risk of kidney disease due to family history of disease, race, high blood pressure or being overweight, Galier advises them to come in a couple times a year for evaluation.Besides counseling about health habits, he said, he usually tests for diabetes and checks their blood pressure.In addition, Hostetter advises those with high blood pressure and some evidence of kidney disease to follow a low-protein diet. He typically sends them to a registered dietitian for a consultation.In general, an average 150-pound person might be told to aim for 50 or 60 grams a day of protein, Hostetter said. “Americans are probably eating more like 100 grams a day.”(Source: Forbes Health, August 2004)