The word “disparity” is defined as a difference in level or treatment, especially, one that is seen as unfair. No matter what race, creed, or color, all patients should be treated fairly and equally! Many patients cannot advocate for themselves—this can also be a problem/obstacle. This article focuses on information about renal health disparities. The DPC Education Center’s intention is to always be a valuable resource.

The information below is retrieved from: Health Publishing, Harvard Medical School (health.harvard.edu).

Many people are surprised to learn that kidney disease does not affect everyone equally. In Reno and across the United States, chronic kidney disease (CKD) and end-stage renal disease (ESRD) occur at much higher rates among racial and ethnic minority populations—especially Black Americans (about four times higher risk), Hispanic Americans (about 2.3 times higher), and Native Americans (about 1.9 times higher) when compared with White Americans. These differences are closely tied to social and economic factors that influence health, including access to medical care, rates of high blood pressure, and diabetes. Because of these barriers, many people in affected communities are diagnosed later, have fewer treatment options, and experience worse health outcomes.

Key Aspects of Kidney Health Disparities

  • Higher disease rates
    Although Black Americans make up roughly 13–14% of the U.S. population, they account for more than 35% of people living with kidney failure.
  • Root causes (social determinants of health)
    Factors such as limited access to health insurance, fewer preventive care visits, food insecurity, and economic stress increase the risk of high blood pressure and diabetes—two leading causes of kidney disease.
  • Transplant access gaps
    Black patients wait, on average, about one year longer for a kidney transplant than White patients and are less likely to be referred for transplant evaluation or placed on a waitlist.
  • Health system challenges
    Long-standing issues in health care delivery—including structural bias and the historical use of race-adjusted clinical tools—have contributed to unequal treatment and delayed care.
  • Overall impact
    These disparities can lead to kidney disease starting earlier in life, progressing more quickly, and causing higher death rates in minority populations.

Understanding the Scope of the Problem

Gaps in kidney care play a major role in health disparities. Data show that non-Hispanic Black, Hispanic, and Native American populations carry a disproportionate burden of kidney disease. For example, for every White person who develops ESRD, approximately three Black individuals develop the condition.

While non-Hispanic Black Americans represent only about 13% of the U.S. population, they make up around 35% of people currently receiving dialysis.

Among patients placed on a kidney transplant waitlist, average waiting times also differ:

  • 64 months for Black patients
  • 57 months for Hispanic patients
  • 37 months for White patients

Why These Differences Exist

Differences in kidney disease rates are influenced by a combination of social factors, genetics, and a higher burden of related conditions such as high blood pressure and diabetes. Barriers to early diagnosis and consistent treatment, especially, in the early stages of kidney, disease play a critical role.

A large retrospective study published in the American Journal of Kidney Diseases reviewed data from more than 800,000 patients who received dialysis or a kidney transplant between 2011 and 2018. Researchers found that White patients were more likely than patients of color to use home dialysis or receive a kidney transplant within 90 days of becoming eligible.

The largest care gap was seen among young adults ages 22 to 24. In this age group:

  • Black patients were 79% less likely
  • Hispanic patients were 53% less likely

to receive a kidney transplant within 90 days compared with White patients. These differences may be related to reduced access to early kidney care, differences in insurance coverage, and lower availability of living kidney donors. The study noted that results may not apply equally to all minority groups.

Bottom Line

The encouraging news is that many cases of kidney disease can be prevented or slowed. Healthy habits—such as eating a low-sodium diet, staying physically active, not smoking, and limiting alcohol—can help protect kidney health. People with high blood pressure, diabetes, heart disease, or high cholesterol should be screened for kidney disease at least once a year.

Because high blood pressure and diabetes occur more often among Black Americans and other people of color, early screening and access to care are especially important. Ongoing research and awareness efforts help shine a light on kidney health disparities and move us closer to solutions that ensure fair, timely, and high-quality care for everyone, regardless of background or age.