Norton Jenna M, Moxey-Mims Marva M, Eggers Paul W, Narva Andrew S, Star Robert A, Kimmel Paul L, Rodgers Griffin P
Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
J Am Soc Nephrol. 2016 Sep;27(9):2576-95. doi: 10.1681/ASN.2016010027. Epub 2016 May 13.
Significant disparities in CKD rates and outcomes exist between black and white Americans. Health disparities are defined as health differences that adversely affect disadvantaged populations, on the basis of one or more health outcomes. CKD is the complex result of genetic and environmental factors, reflecting the balance of nature and nurture. Social determinants of health have an important role as environmental components, especially for black populations, who are disproportionately disadvantaged. Understanding the social determinants of health and appreciating the underlying differences associated with meaningful clinical outcomes may help nephrologists treat all their patients with CKD in an optimal manner. Altering the social determinants of health, although difficult, may embody important policy and research efforts, with the ultimate goal of improving outcomes for patients with kidney diseases, and minimizing the disparities between groups.
美国黑人和白人在慢性肾脏病（CKD）发病率及预后方面存在显著差异。健康差异被定义为基于一种或多种健康结局而对弱势群体产生不利影响的健康差异。CKD是遗传和环境因素的复杂结果，反映了先天与后天的平衡。健康的社会决定因素作为环境因素发挥着重要作用，对于处于极度不利地位的黑人人群而言尤其如此。了解健康的社会决定因素并认识到与有意义的临床结局相关的潜在差异，可能有助于肾病学家以最佳方式治疗所有CKD患者。改变健康的社会决定因素虽然困难，但可能需要重要的政策和研究努力，其最终目标是改善肾病患者的预后，并尽量减少不同群体之间的差异。
