Understanding kidney disease risks Race and ethnicity

Who is at higher risk for kidney disease?

Chronic kidney disease (CKD) affects people of all racial and ethnic backgrounds, but due to genetic, socioeconomic, and barriers to healthcare access, Black, Hispanic or Latino, Asian, and Native American communities are at a higher risk. People in these communities are more likely to be diagnosed at later stages when treatment options are more limited. By understanding these risk factors, you can better protect your kidneys and advocate for the care you need.

Why are some groups at higher risk?

Diabetes 

Diabetes is the number one cause of kidney failure, responsible for nearly 40% of all cases in the United States. In the last 35 years, the number of people with diabetes has doubled.

Diabetes disproportionately affects communities of color. While 1 in 14 white adults in the U.S. have diabetes (6.9%):

• 1 in 7 Native American adults has diabetes (13.6%)
• 1 in 8 non-Hispanic Black adults has diabetes (12.1%)
• 1 in 8 Hispanic or Latino adults has diabetes (11.7%)
• 1 in 11 non-Hispanic Asian adults has diabetes (9.1%)

Genetics

Recent research suggests that genetic factors, such as variants in the APOL1 gene, may lead to an increased risk of CKD and kidney failure among Black Americans. While not everyone with these variants will develop kidney disease, they can make it more likely, especially when combined with other risk factors. 

Genetic testing can help identify inherited conditions like polycystic kidney disease (PKD) or Fabry disease, ensuring a more accurate diagnosis and personalized treatment plan. It can also clarify family risk, aiding in family planning and early detection for relatives. Understanding the genetic cause of your CKD can empower you and your healthcare providers to make informed decisions about your care and disease management. Learn more about genetic testing.

Genetic testing may also provide access to clinical trials, offering new treatment options. Diversity in clinical trials is important to ensuring that new treatments work for everyone. Increasing representation in clinical research helps improve health outcomes and health equity for communities that have been historically underrepresented.

Socioeconomic factors

Socioeconomic factors are social and financial circumstances that affect the opportunities and quality of life of certain communities. Many people in underserved communities face challenges such as:

Access to healthy foods – Fresh fruits, vegetables, and low-sodium foods may be harder to find in some neighborhoods, increasing the risk of conditions like diabetes and high blood pressure.

Access to transportation - Needing to rely on public transportation or not having a transportation option can lead to missed appointments and delays in getting prescription medicines. Delays in treatment can cause health conditions to get worse.

Healthcare provider bias – Some communities may receive different levels of care due to bias or assumptions made about their race or ethnicity by healthcare providers. This can mean people of color may receive different levels of care even when they have the same symptoms or medical conditions as white people.

Access to healthcare

Without insurance, routine check-ups and early kidney disease screenings may not be affordable, leading to later diagnoses and fewer treatment options.

• 1 in 10 Black Americans are uninsured, limiting access to routine screenings and preventive care.
• 1 in 6 Asian Americans and Pacific Islanders are uninsured.
• 1 in 4 Hispanic and Native Americans are uninsured, often facing additional challenges such as language barriers.

How do I protect my kidneys?

While you can't control every risk factor, there are key steps you can take to protect your kidneys:

1. Tests like estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR) tests are important for detecting CKD early and personalizing treatment options. If you catch and treat kidney disease early, you can prevent it from getting worse.
2. Eat healthy foods low in salt, fat, and cholesterol and high in fiber. Limit how much alcohol you drink.
3. Exercise, keep a healthy weight, do not smoke or use tobacco, and treat bladder and kidney infections fast.
4. Manage diabetes and high blood pressure, the leading causes of kidney failure.  

Advancing equity in kidney care

Health disparities in kidney disease are real — but so are the solutions. The Kidney Health for All initiative is dedicated to advancing health equity, increasing access to care, and empowering at-risk communities. Learn how to take charge of your kidney health and advocate for yourself and your loved ones.