Chronic Kidney Disease is an Urgent Health Crisis in the Black Community

At the age of 21, I crashed onto dialysis, meaning I walked into an emergency room after feeling unwell, learned I was in kidney failure, and needed to begin dialysis urgently. My story is far too common in the Black community. What is also far too common is the saturation of dialysis centers in urban, underresourced communities. While dialysis centers provide essential life-saving services, they also underscore a troubling reality: the overwhelming presence of these medical facilities dedicated to treating individuals with kidney failure starkly reveals the emergent healthcare needs within our communities. Black individuals bear a disproportionate burden when it comes to chronic kidney disease (CKD). 

We have a higher prevalence of hypertension and diabetes, the two leading contributors to CKD. Beyond these medical factors, there are also substantial non-medical influences at play. Social and economic injustices, including systemic racism, play a critical role in the higher rates of CKD among Black communities. These injustices can manifest in various ways, such as limited access to quality healthcare, educational disparities, and socioeconomic barriers, all of which can hinder preventative care, disease management, and quality of life. As a result, Black individuals often face a compounded risk for CKD, making it essential to address both the medical and broader societal factors that contribute to this health disparity.

I did not have health insurance when my kidneys failed, which is not unique in lower-income populations. Once a person reaches advanced stages of kidney disease that require dialysis to live, Medicare provides medical coverage for dialysis treatment and chronic disease management. Fortunately, my physician prescribed a home dialysis modality, peritoneal dialysis, which I could do in the privacy of my home and remain active as a college student. After two years on peritoneal dialysis, a dear college friend, Kellye, donated her kidney to me. My transplanted kidney is still doing well, nearly 18 years later. This particular part of my kidney health journey is not common.

Many people in the Black community are not educated by their care team about treatments for kidney failure beyond in-center dialysis. However, home dialysis often provides kidney patients with a better quality of life, usually allowing for greater flexibility and improved health outcomes compared to in-center dialysis. Kidney transplantation is the optimal therapy for kidney failure, but without proper awareness and education, people do not know to explore these treatment options outside of in-center dialysis.

Here are a few ways to be empowered when it comes to taking control of your kidney health:

• Take a quiz by the National Kidney Foundation to see if you are at risk for CKD. Are You The 33% Quiz?
• Ask your physician to screen your kidneys for CKD. Screening for kidney disease requires a urine and blood sample, which your care team usually requests during your annual check-up.
• Advocate for yourself and others. Ask your physician to tell you about all of your treatment options related to CKD. Ask about preventative treatment options and all therapies to treat kidney failure, like home dialysis and kidney transplantation. Advocate for policies to improve kidney care in the United States by joining organizations like the National Kidney Foundation as a patient advocate.
• Talk to your friends, family, and community. Managing CKD can be a challenge, and dealing with a kidney failure diagnosis can be hard. Talk to your loved ones, ask for help, take them to your doctor visits for support, and talk to them about kidney transplantation. 

Kidney disease is a public health crisis for Black people, but it does not have to be. To join the fight against kidney disease, visit the National Kidney Foundation website at www.kidney.org.