Racial Disparities in CKD Flashcards
Define racial disparities
Racial disparities in health are differences that adversely affects disadvantaged populations based on one or more health outcomes, usually resulting from the operation of healthcare systems, legal and regulatory
climates, and discriminatory biases.
Define racial differences
Racial differences in health are clinical, biological, genetic, or epigenetic factors associated with disease risk or outcome not caused by social factors that vary among population groups.
What are the 3 main socioeconomic factors responsible for CKD racial disparities?
- access (preventative care and nephrology referrals)
- access to kidney transplant
- living and working conditions
What are three direct and indirect modifiers of CKD progression that are impacted by living and working conditions disparities?
toxic waste exposure
walkable areas
food deserts
Define APOL-1 nephropathy
The APOL1 gene has been linked to increased risk of non-diabetic CKD and ESKD development among African Americans. CKD thought to be caused by APOL1-related biology is referred to as APOL1 nephropathy, APOL1-associated kidney disease, or APOL1-mediated kidney disease. APOL1-mediated kidney disease has diverse presentations and contributes to the following types of kidney disease:
• Focal segmental glomerulosclerosis (FSGS) • HIV-associated nephropathy
• Sickle cell nephropathy
• Severe lupus nephritis
• Hypertension-associated ESKD
If someone has a high risk APOl 1 genotype, what does this mean for their risk of developing kidney disease?
they are more likely to get the disease following an exposure or process than someone with an equivalent history
Which APOl 1 variants are thought to provide a survival benefit against african trypanosomiasis?
G1 and G2
What kind of penetrance do APOl 1 high risk alleles have?
incomplete penetrance
What is the distinction between racial differences and racial disparities?
Racial differences in CKD are driven by clinical, biological, genetic, and epigenetic factors while racial disparities in healthcare outcomes arise from socioeconomic factors.
How do racial disparities in access affect kidney care?
Reduced access to routine preventative, prenatal, and nephrology care associate with increased incidence of CKD among African Americans, who also as a group have reduced access to kidney transplantation evaluation and listing.
What is the high-risk APOL1 genotype, and how does it factor into CKD?
The high-risk APOL1 genotype is homozygosity (G1/G1, G2/G2) or compound heterozygosity (G1/G2) for CKD risk alleles. Unlike individuals who have only one risk allele (G0/G1, G0/G2), individuals with the high- risk genotype are at increased risk for developing CKD. However, only a portion of individuals with the high- risk genotype develop disease, consistent with incomplete penetrance.
