Racial Disparities in Self-Management of Chronic Kidney Disease

According to the United States Renal Data System, approximately one million people initiated chronic dialysis treatment over the past decade in the United States and the first-year mortality rate of this population in 2007 was reported to be 19.6% . Previous studies support that patient education for chronic kidney disease (CKD) management including diet, medication, and treatment adherence is not only significant to effective self-management but also to reduce multiple co-morbidities and mortality rates. It also improves patient outcomes within the first year of initiating dialysis. Therefore, aggressive patient education regarding CKD management with initiation of hemodialysis is currently performed in most dialysis units. Although patient education is provided equally, disparities in CKD self-management among racial and ethnic groups remain. To identify contributing factors regarding these disparities, individual in-depth interviews were conducted with 15 patients from a hemodialysis clinic in Houston, Texas. Three major findings emerged from the in-depth interviews: 1) racial and ethnic minority groups including African American, Hispanic and Asian populations showed lower self-management regarding CKD than Caucasians; 2) disparities in self-management also existed among these racial and ethnic minority groups; and 3) different contributing factors regarding disparities in self-management were identified in each racial and ethnic minority group. To eliminate racial disparities in self-management of CKD, this study suggests providing tailored patient education for CKD management by recognition of the differences among these racial and ethnic minority groups.