Health Equity and Chronic Kidney Disease

Chronic kidney disease (CKD) affects 37 million and many others are at increased risk.

In fact, 1 in 3 people are at risk for CKD and most do not even know it.

Anyone can have CKD – at any age. However, some people are more likely than others to develop CKD. The 2 most common CKD risk factors are diabetes and/or high blood pressure (hypertension). You may have an increased risk for developing CKD if you are overweight or obese, over 60 years of age, have heart disease or heart failure, and/or have family members who have had CKD or kidney failure.

Usually, developing CKD is not due to any single reason, but a combination of other factors called social determinants of health (SDoH), which are things like where you live, how much money you have, your education level, and if you can get needed medical care.

Is race a risk factor for CKD?

Over 37 million adults in the United States have CKD – and the people who are most at risk self-identify their race as:

• Black/African American
• Hispanic/Latino
• American Indian/Alaska Native
• Asian American
• Native Hawaiian/Other Pacific Islander
• Biracial
• Multiracial

Knowing you may be at risk for developing CKD is the first step toward leading a healthier life. We’ve made it easier than ever to see. Take the Minute for your Kidneys quiz and find out if you are at risk.

Health equality means everyone has the same resources and opportunities for good health. While on the surface, this may seem fair, think about how some people may need different resources or support than others to be healthy.

Health equity, on the other hand, means that the right resources and support are given to people based on what they need for good health – even when that means they may need other kinds of assistance. Health equity is fairer because it considers that everyone may not need the same things.

In other words, health equality focuses on treating everyone the same, while health equity focuses on providing everyone with what they need. These differences in health problems and solutions between different groups of Americans are called health disparities.

Health inequities are directly related to and arise from SDoH. For example, if you live in an area with lots of pollution, you may be more likely to have health problems like asthma. Or if you don't have enough money to buy healthy food, you may not be able to eat well and may be more likely to develop diseases such as diabetes, high blood pressure, or other health problems.

SDoH and health inequities are responsible for the high rate of diabetes, the most common risk factor for developing CKD, in Black/African American, Hispanic/Latino, and American Indian/Alaska Native adults.

High blood pressure (hypertension), another leading cause of CKD, disproportionally affects many Black/African American and Hispanic/Latino adults.

Although Black/African American people make up around 12% of the population in the US, their rate of kidney failure is 35%.

In 2021, about 1.5 million more people had health insurance compared to 2019. This was due to policies that helped people who lost jobs or income during the pandemic. The Families First Coronavirus Response Act (FFCRA) was a temporary law that allowed some people to get Medicaid coverage, such as paid sick leave, medical leave, and expanded family benefits. In addition, people could also buy health insurance through the Healthcare Insurance Marketplace, created by the Affordable Care Act (ACA).

Earlier this year, the FFCRA reached its expiration date, and the specific benefits it offered are no longer available. It is estimated that about 17 million people who qualified for Medicaid during the pandemic, will lose their coverage by mid 2024.

Changes in Medicaid eligibility will affect children and young adults the most – it is expected that 1 in 3 young adults, aged 18-34, risk losing their Medicaid coverage. More than 1 in 4 Hispanic/Latino people and 14% of Black/African American people will likely no longer be eligible.

People of color have been disproportionally affected by not having health insurance coverage for necessary medical care. For example, the most recent data from 2021 showed that about 1 in 4 people who identify as Hispanic/Latino or American Indian/Alaska Native and 14% of Black/African American adults between the ages of 19 and 64 did not have health insurance.

While many are at risk for developing CKD, not everyone does. There are usually a number of factors that come together to cause the disease. Remember, knowing the risk factors allows you to take charge of your health. If you have any risk factors, you should:

• Get tested for kidney disease. There are two simple tests for kidney disease:
  • A simple urine (pee) test checks to see if you have protein in your urine. Your body needs protein. But it should only be in the blood, not your urine. Having a small amount of protein in your urine may mean your kidneys are not filtering your blood well enough and can be an early sign of kidney disease.
  • A simple blood test for eGFR, which stands for estimated glomerular filtration rate. Your eGFR number tells you how well your kidneys are working. Labs calculate eGFR using creatinine levels (a normal waste product in the blood), along with your age and gender.
• 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 for you to find out.
• Live a healthy lifestyle. Be sure to exercise, eat a healthy diet, lose weight if needed, stop smoking, and limit alcohol use. A healthy lifestyle may prevent CKD from developing, and it can also help slow or stop CKD from getting worse.

Call toll-free at 855.NKF.CARES (855.653.2273) or email nkfcares@kidney.org.

We speak English and Spanish and are available Monday - Friday from 9:00 am - 7:00 pm Eastern Time.

This content is provided for informational use only and is not intended as medical advice or as a substitute for the medical advice of a healthcare professional.