Prevalence and Awareness of CKD Among African Americans: The Jackson Heart Study

Received 10 April 2008; accepted 29 August 2008.

Background

Chronic kidney disease (CKD) leads to end-stage renal disease and is a growing epidemic throughout the world. In the United States, African Americans have an incidence of end-stage renal disease 4 times that of whites.

Study Design

Cross-sectional to examine the prevalence and awareness of CKD in African Americans.

Setting & Participants

Observational cohort in the Jackson Heart Study (JHS).

Predictor

CKD was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m2, the presence of albuminuria, or dialysis therapy.

Outcomes & Measurements

Data from the JHS were analyzed. Medical history, including disease awareness and drug therapy, anthropometric measurements, and serum and urine samples, were obtained from JHS participants at the baseline visit. Associations between CKD prevalence and awareness and selected demographic, socioeconomic, health care access, and disease status parameters were assessed by using logistic regression models.

Results

The prevalence of CKD in the JHS was 20%; CKD awareness was only 15.8%. Older participants had a greater prevalence, but also were more aware of CKD. Hypertension, diabetes, cardiovascular disease, hypercholesterolemia, hypertriglyceridemia, increasing age and waist circumference, and being single or less physically active were associated with CKD. Only advancing CKD stage was associated with awareness.

Limitations

Cross-sectional assessment, single urine measurement.

Conclusions

The JHS has a high prevalence and low awareness of CKD, especially in those with less severe disease status. This emphasizes the need for earlier diagnosis and increased education of health care providers and the general population.

Index Words: Renal insufficiency, proteinuria, African American, chronic disease, epidemiology, population

1 Department of Medicine, University of Mississippi Medical Center, Jackson, MS

2 School of Nursing, University of Mississippi Medical Center, Jackson, MS

3 Jackson Heart Study, Jackson State University, Jackson, MS

4 National Heart, Lung, and Blood Institute, Bethesda, MD

5 University of South Alabama, Mobile, AL

Address correspondence to Michael F. Flessner, MD, PhD, John Bower Professor and Chair, Division of Nephrology, School of Medicine, University of Mississippi Medical Center, 2500 North State St, Jackson, MS 39216-4505

PII: S0272-6386(08)01575-8

doi:10.1053/j.ajkd.2008.08.035

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