In-Depth Topic Review

The Role of Anemia Management in Improving Outcomes for African-Americans with Chronic Kidney Disease
Janice P. Lea^a, Keith Norris^b, Lawrence Agodoa<sup>c

a</sup>Department of Medicine, Emory University, Renal Division, Atlanta, Ga.,
^bClinical Research Center, Charles R. Drew University of Medicine and Science, and David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, Calif., and
^cChronic Kidney Disease and End Stage Renal Disease Programs and Office of Minority Health Research Coordination, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md., USA

Address of Corresponding Author

Am J Nephrol 2008;28:732-743 (DOI: 10.1159/000127981)

  Key Words

• Anemia management
• Diabetes mellitus
• Hypertension
• Chronic kidney disease
• Dialysis

  Abstract

Chronic kidney disease (CKD) is a serious threat to African-American public health. In this population CKD progresses to end-stage renal disease (ESRD) at quadruple the rate in Caucasians. Factors fueling progression to ESRD include diabetes and hypertension, which show high prevalences and accelerated renal damage in African- Americans, as well as possible nutritional, socioeconomic, and genetic factors. Anemia, a common and deleterious complication of CKD, is more prevalent and severe in African-American than Caucasian patients at each stage of the disease. Proactive management of diabetes, hypertension, anemia, and other complications throughout the course of CKD can prevent or delay disease progression and alleviate the burden of ESRD for the African-American community. Currently, African-Americans with CKD are less likely than Caucasian patients to receive anemia treatment before and after the onset of dialysis. Although African-Americans often require higher doses of erythropoiesis-stimulating agents, this may result from late treatment initiation, lower hemoglobin levels, or the presence of comorbidities such as diabetes and inflammation, although racial differences in response cannot be excluded. This review explores racial-specific challenges and potential solutions in renal anemia management to improve outcomes in African-American patients.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Janice P. Lea, MD, MSc
Department of Medicine - Renal Division
550 Peachtree Street
Atlanta, GA 30308 (USA)
Tel. +1 404 686 5038, Fax +1 404 686 4995, E-Mail jlea@emory.edu

  Article Information

Received: October 3, 2007
Accepted: March 4, 2008
Published online: April 24, 2008
Number of Print Pages : 12
Number of Figures : 0, Number of Tables : 3, Number of References : 132