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"Findings identify barriers to kidney disease screening among black Americans" published by Dr. Ebele Umeukeje

May 14th 2018

"Findings identify barriers to kidney disease screening among black Americans" published in Nephrology News and Issues

Umeukeje EM, et al. CJAS. 2017;doi:10.2215/CJN.0750717

March 15, 2018

As the incidence of kidney failure is three-times higher in black Americans than whites and chronic kidney disease prevalence continues to rise among black Americans, findings recently published in the Clinical Journal of the American Society of Nephrology highlight barriers to kidney disease screening among this population.

According to the study, community-based kidney screening is one strategy that could increase early identification and awareness of black Americans at risk, but implementation is difficult. Ebele M. Umeukeje, MD, MPH, from Vanderbilt University Medical Center, and colleagues performed three focus groups of black American adults, all from churches in Nashville, to help identify their perspectives on barriers and facilitators of community-based kidney screenings.

“We identified person-centered and programmatic factors as the two broad categories of barriers to kidney disease screening. Limited kidney disease awareness, low trust, poor communication and religiosity were the most important person-centered factors, while programmatic factors included poor advertisement and lack of convenience, incentives and privacy,” Umeukeje told Healio Nephrology. “Black Americans feel that there is a paucity of information about chronic kidney disease unlike other chronic disease conditions, including breast cancer and heart disease.”

The study of 32 people showed low trust among black Americans toward their doctors influenced decisions to be screened. One participant expressed concern that urine samples may be used for drug screening instead of detecting protein in the urine, a marker of kidney disease. There was also a fear among men that the side effects of medication could impact their libido.

When talking about possible solutions, Umeukeje said, “The establishment of strong collaborative partnership with community leaders, religious leaders and stakeholders is critical for building trust and successfully disseminating information among African Americans, to improve participation in kidney disease screening events.”

In an accompanying editorial, Keith C. Norris, MD, PhD, FACP, FASN, and Susanne B. Nicholas, MD, MPH, PhD, from David Geffen School of Medicine at UCLA, noted that the study provides a timely and well-balanced set of recommendations for attempting to engage and build trust among black Americans. - by Jake Scott