National Kidney Disease Education Program, National Institute of Diabetes and Digestive and Kidney Diseases, Clinical Consultant for Nephrology, Indian Health Service, Bethesda, MD 20892-5458, USA.
Semin Nephrol. 2010 Jan;30(1):19-25. doi: 10.1016/j.semnephrol.2009.10.007.
American Indians and Alaska Natives comprise a diverse population with an increased burden of chronic kidney disease (CKD), largely owing to diabetes. Although transportation to rural dialysis units impairs access, quality of dialysis care appears similar to the US population. Similar to other racial and ethnic minorities, American Indians and Alaska Natives are less likely to receive kidney transplants. The causes of these disparities are as diverse as the population. The application of the chronic care model to CKD by the Indian Health Service is associated with a decrease in incidence of end-stage renal disease among diabetic patients and may be a useful model for reducing disparities in other populations at risk for CKD.
美国印第安人和阿拉斯加原住民是一个多样化的群体，患有慢性肾脏病（CKD）的负担加重，主要是由于糖尿病。尽管前往农村透析单位的交通会影响获得治疗的机会，但透析护理的质量似乎与美国人群相似。与其他少数族裔一样，美国印第安人和阿拉斯加原住民接受肾脏移植的可能性较小。造成这些差异的原因与人群一样多样化。美国印第安人健康服务部将慢性病护理模式应用于 CKD，与糖尿病患者终末期肾病的发病率下降有关，对于减少其他有患 CKD 风险的人群中的差异，这可能是一个有用的模式。
