Why Black Americans are at higher risk of chronic kidney disease

Chronic kidney disease is a condition where your kidneys lose their ability to filter waste and fluid from your blood. This can lead to serious health problems such as heart disease, stroke and kidney failure.

The Black community faces a higher risk of chronic kidney disease. This can be due to genetics, higher rates of hypertension and diabetes, and socioeconomic issues such as access to health care and structural racism.

Dr. Ivan Porter II, a Mayo Clinic nephrologist, says these factors create a cycle that increases the risk of chronic kidney disease. And there are ways to help reduce the risks.

“There are multiple factors that correspond to African Americans, Black individuals having more chronic kidney disease,” says Dr. Porter.

That includes diet—which also plays a role in diabetes and high blood pressure, the leading causes of chronic kidney disease.

“If you have a population that is affected more by those socioeconomic circumstances, certainly they’re going to have worse health outcomes because of it,” says Dr. Porter.

There is also a genetic factor. An estimated 13% of Black Americans have a gene variation that puts them at higher risk.

“APOL1 is a genetic variant that’s been recognized. It’s an abbreviation of apolipoprotein L1,” he explains.

Not everyone who has the gene variation has kidney disease, but the presence makes the risk of chronic kidney disease more likely.

“Those socioeconomic factors, and hypertension and diabetes, make someone with those genetic factors more likely to develop kidney disease as well,” Dr. Porter says.

Preventing chronic kidney disease

That’s why awareness can lead to prevention.

“We can’t change our genetics. We certainly can control our blood pressure. We can make a difference with our diabetes control. We can try to eat healthier. We can try to exercise—all things that we know correspond to less diabetes, less hypertension and, because of that, less kidney disease,” says Dr. Porter.

Test for gene mutation

Dr. Porter says there are tests for the APOL1 gene through your primary care clinician or nephrologist. He says knowing if you have the gene can help with early detection and disease medication.

“Getting that testing done will hopefully make an impact in how we treat the disease and how outcomes in the disease affect our populations,” says Dr. Porter.