Benabe Julio E, Rios Elena V
Medical Service, San Juan Veterans Affairs Medical Center, San Juan, Puerto Rico.
J Natl Med Assoc. 2004 Jun;96(6):789-98.
The incidence of kidney disease in the United States is rising at a steady, alarming pace. The growth rate has been particularly rapid for end-stage renal disease (ESRD), which has been reported to double every 10 years. Of even greater concern is the emergence of striking racial disparities in the prevalence, morbidity, and mortality of kidney disease, and in the provision of optimal care to prevent or slow progression of the disease. Hispanics, who are among the fastest-growing racial groups in the United States, are twice as likely to develop kidney failure as non-Hispanic whites, largely due to the increased prevalence of diabetes mellitus in the Hispanic population. However, Hispanic patients are less likely than the general U.S. population to be screened for risk factors for kidney disease or receive optimal treatment after diagnosis. Several actions are required to redress these racial inequalities. Improved cultural sensitivity on the part of physicians is fundamentally important, as are patient education programs targeted specifically at the diverse Hispanic groups. In addition, local initiatives should be supported on a wider scale by healthcare policymakers to encourage improved medical care within Hispanic communities and thereby reduce the burden of kidney disease on American society as a whole.
美国肾脏疾病的发病率正以稳定且惊人的速度上升。终末期肾病(ESRD)的增长率尤为迅速,据报道每10年就会翻倍。更令人担忧的是,在肾脏疾病的患病率、发病率和死亡率以及提供预防或减缓疾病进展的最佳护理方面,出现了显著的种族差异。西班牙裔是美国增长最快的种族群体之一,他们患肾衰竭的可能性是非西班牙裔白人的两倍,这主要是由于西班牙裔人群中糖尿病患病率的增加。然而,与美国普通人群相比,西班牙裔患者接受肾脏疾病风险因素筛查或诊断后接受最佳治疗的可能性较小。需要采取多项行动来纠正这些种族不平等现象。医生提高文化敏感度至关重要,专门针对不同西班牙裔群体的患者教育项目也同样重要。此外,医疗保健政策制定者应在更广泛的范围内支持地方倡议,以鼓励改善西班牙裔社区内的医疗服务,从而减轻整个美国社会的肾脏疾病负担。