Nelson Maxine L, Buchanan-Peart Keri-Ann R, Oribhabor Geraldine I, Khokale Rhutuja V, Cancarevic Ivan
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Obstetrics and Gynecology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2020 Jul 31;12(7):e9499. doi: 10.7759/cureus.9499.
The prevalence of chronic kidney disease (CKD) is increasingly becoming recognized as a global health concern as well as a critical determinant of poor health outcomes. Decreased access to health care and low socioeconomic status (SES) worsen the adverse effects of biologic or genetic predisposition to CKD. All the studies used were retrieved using the PubMed database. The literature suggests that in developing and developed countries, lower SES is inversely proportional to CKD. It shows an inconsistent relationship between CKD and race; that is, there may or may not be a relationship between these two variables. In the United States (US), the prevalence of the early stages of CKD is similar across different racial/ethnic groups. However, the preponderance of end-stage renal disease (ESRD) is higher for minorities than their non-Hispanic white counterparts. Further investigation is required to understand the role of racial disparities and CKD as well as to understand the significant difference seen in the incidence when progressing from CKD to ESRD. It is necessary to recognize how lower SES and racial/ethnic disparity may result in the impediment of appropriate disease management. A possible approach is the use of the biopsychosocial model, which integrates biological, individual, and neighborhood factors. A practical method of providing appropriate care to these populations will require economically feasible prevention strategies as well as extending the scope of dialysis by the implementation of cheaper alternatives.
慢性肾脏病（CKD）的患病率日益被视为一个全球健康问题，也是健康不良结局的关键决定因素。获得医疗保健的机会减少和社会经济地位（SES）低下会加剧CKD的生物学或遗传易感性的不良影响。所有使用的研究均通过PubMed数据库检索。文献表明，在发展中国家和发达国家，较低的SES与CKD呈负相关。它显示了CKD与种族之间的关系不一致；也就是说，这两个变量之间可能有关系，也可能没有关系。在美国，不同种族/族裔群体中CKD早期阶段的患病率相似。然而，少数族裔终末期肾病（ESRD）的患病率高于非西班牙裔白人。需要进一步调查以了解种族差异和CKD的作用，以及了解从CKD进展到ESRD时发病率的显著差异。有必要认识到较低的SES和种族/族裔差异如何可能导致适当疾病管理的障碍。一种可能的方法是使用生物心理社会模型，该模型整合了生物学、个体和社区因素。为这些人群提供适当护理的实用方法将需要经济上可行的预防策略，并通过实施更便宜的替代方案来扩大透析范围。
