Asian Americans have a higher risk for kidney disease and kidney failure than white Americans. The reasons why are not fully understood. However, diabetes seems to be one reason. High blood pressure, diet, and access to healthcare may also play a role.
What is kidney disease?
Healthy kidneys do many important jobs. They remove waste products and extra water from your body, help make red blood cells, and help control blood pressure. When you have kidney disease, it means your kidneys are damaged and they cannot do these important jobs well enough. Kidneys can become damaged from an physical injury or a disease like diabetes, high blood pressure, or other disorders.
If you have kidney disease, you will need to follow a treatment plan that may include taking medicines, restricting salt, limiting certain foods, getting exercise, and more.
Finding and treating kidney disease early can help slow or even stop kidney disease from getting worse. But if kidney disease gets worse, it can lead to kidney failure. Once kidneys fail, treatment with dialysis or a kidney transplant is needed to stay alive.
Can anyone get kidney disease?
Yes. Anyone can get kidney disease at any age. But some people are more likely than others to get it, including Asian Americans. Your risk for getting kidney disease is greater if you have diabetes, high blood pressure, a family history of chronic kidney disease, or are 60 years or older. Being Asian American, African American, Hispanic, Pacific Islander or American Indian also means you are at greater risk. The more risk factors you have, the greater your risk of getting kidney disease.
Why are Asian Americans at greater risk for kidney disease?
Diabetes is a growing problem among Asian Americans. According to U.S. Department of Health and Human Services, the risk of diabetes is 18% higher among Asian Americans than white Americans. Having diabetes can lead to kidney disease. In fact, diabetes is the leading cause of kidney disease and kidney failure.
The rise in diabetes among Asian Americans may be the result of eating an American or "western" diet. Studies have shown that Asians who move to the United States and adopt an American diet have higher rates of diabetes. The traditional Asian diet, which consists mostly of plants and fish, is low in fat. But the American diet is high in calories and fat. According to multiple studies, Japanese Americans who live in the United States have much higher rates of diabetes than Japanese who live in Japan. Likewise, Chinese Americans have higher rates of diabetes than Chinese who live in rural China.
Heredity and body composition may also play a role. Studies show that Asian Americans get diabetes at a much lower body weight than white Americans. In other words, the risk for diabetes rises sharply in Asian Americans with even a small amount of weight gain above the appropriate target for their ethnicity.
Lack of exercise may also be a factor. As with diet, Asian Americans may also be adopting an inactive lifestyle. In past generations, many Asian Americans had jobs that required physical labor. That is not the case today. Lack of exercise has been shown to increase a person's risk for diabetes.
How does access to healthcare play a role?
Asian Americans may have less access to healthcare than white Americans. For example, the percentage of Asian Americans who are uninsured is higher than white Americans. And other factors may be involved as well. A recent study compared Asian American's experience with healthcare to white American's. According to the study, Asian Americans were less likely than whites to report that their doctors ever talked to them about lifestyle or mental health issues. They were more likely to report that their regular doctors did not understand their background and values. When asked about the last visit, they were more likely to report that their doctors did not listen, spend as much time, or involve them in decisions about care as much as they wanted. Research in this area is still limited, and more needs to be done.
What to do?
Not all Asian Americans will get kidney disease. And not everyone who has diabetes, high blood pressure, heart disease, older age, or a family history of kidney disease will get it. But if you have any of these risk factors, you should:
- Get tested for kidney disease. There are two simple tests for kidney disease:
- A simple urine test checks to see if you have protein in your urine. Your body needs protein. But it should be in the blood, not the urine. Having a small amount of protein in your urine may mean that your kidneys are not filtering your blood well enough. This can be a sign of early kidney disease.
- A simple blood test for GFR, which stands for glomerular filtration rate. Your GFR number tells you how well your kidneys are working. Your GFR is estimated from a simple blood test for a waste product called creatinine. Your creatinine number is used in a math formula along with your age, race, and gender to find your GFR.
- Get tested for diabetes, high blood pressure, and heart disease. If you don't know whether you have diabetes, high blood pressure, or heart disease, it's important to find out.
- Live a healthy lifestyle. Be sure to exercise, eat healthy, lose weight if needed, avoid smoking, and limit alcohol. A healthy lifestyle can keep you from getting kidney disease, and it can also help slow or stop kidney disease from getting worse.
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© 2014 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.