Did you know African Americans are at increased risk of developing chronic kidney disease leading to dialysis and transplant? Compared with other ethnic groups, the African-American population has higher rates of diabetes and high blood pressure, the two leading causes of kidney disease.
Almost one in every three African Americans has high blood pressure. Because there are no warning signs, frequently people have high blood pressure or kidney disease and don’t even know they have a health problem. Even diabetes doesn’t always have symptoms.
Many African Americans already know they have diabetes or high blood pressure but are not aware they may also have kidney disease. They are shocked to be diagnosed with kidney failure and then immediately begin dialysis. Even though their kidney disease progressed over time to kidney failure, it’s as if it happened suddenly.
Talking about race is never just black and white, but when it comes to health, this is crystal clear: Racial disparities exist and a variety of factors, including genetics, seem to play a role.
Time and space for this column don’t permit me to go into the “whys and wherefores”; I am dealing only with the “what is” as it relates to Black folks.
Black Americans are three times more likely than white Americans to develop kidney disease and to require dialysis. This is both a troubling statement and a sad reality for the African-American population. Of great concern is that this racial disparity remains constant across all age groups. It may not make many headlines, but it needs to be brought to the attention of the public.
Given the staggering rates of kidney disease in the African-American community, African Americans need to pay particular attention to their kidney health. Kidney disease often has no symptoms until it is very advanced, so it can go unnoticed.
But the news is not all grim. Lifestyle changes can make a big difference in reducing one’s risk for developing kidney disease, and early testing and treatment can slow or prevent the progression of kidney disease and its complications. As the saying goes, an ounce of prevention truly is worth a pound of cure.
Dialysis treatment — either in a hospital, at a dialysis unit or at home — is needed when the kidneys cannot filter wastes from the body sufficiently. This is what is known as kidney failure.
The most common form of treatment for end-stage renal disease (ESRD, or kidney failure) is hemodialysis.
Life expectancy drops severely after kidney failure, when the kidneys are functioning at or below 15% — also termed end stage or stage 5 kidney failure.
Kidney failure life expectancy depends on many things, some of which you can control, and others that you cannot control: age, gender, genes, race, diet, lifestyle choices, what caused the condition, the type of treatment, etc.
Each year, about 37,000 dialysis patients in the United States develop potentially deadly bloodstream infections associated with their treatment, the Centers for Disease Control says.
Estimates are that between 10 percent and 30 percent of dialysis patients carry the hepatitis C virus, compared with 1 percent of the non-dialysis general population.
Most people acquire the virus during blood transfusions, and kidney patients, who sometimes suffer severe anemia, are more likely to have transfusions. If a medical facility does not follow guidelines for infection control correctly, it is possible for patients to get hepatitis C from being on dialysis.
A number of factors can contribute to a higher risk of infections in dialysis patients, including a close distance between dialysis patients, a fast patient turnover between dialysis sessions, and the health of the patient.
Many dialysis patients, particularly African Americans, have other health conditions or a weakened immune system that can increase susceptibility to infections, especially when infection-prevention practices are not strictly followed by dialysis staff. These health conditions often result in dialysis patients having frequent admissions to hospitals, which expose them to antibiotic therapy and drug-resistant bacteria.
In the early years of dialysis, there was a danger of getting hepatitis B through exposure to the blood of an infected person at a dialysis unit. However, today the chance of getting hepatitis B through treatment is very small because of two important advances — the use of strict infection-control measures in dialysis units and the availability of a vaccination for hepatitis B.
This is all good news. There are new treatments for Hepatitis C and a cure is now possible in most cases, including dialysis and kidney transplant patients.
Remember, I’m not a doctor. I just sound like one.