The prevention and treatment of kidney disease pose an ever-increasing healthcare challenge in the United States. Currently, over six million Americans have significant reductions in kidney function, and nearly 400,000 require dialysis or a kidney transplant to stay alive. Kidney disease is escalating, and the incidence of end-stage renal disease (ESRD) has been increasing at a rate of up to 9% per year. Forecasts indicate that by the year 2010 there will be over 650,000 patients with ESRD in the United States.
While the rate of kidney disease is rising throughout the adult U.S. population, it is expanding faster in certain ethnic groups—in particular, African-American and Hispanic populations—than in whites. Hispanics are twice as likely to develop kidney failure as non-Hispanic whites. official canadian pharmacy
Not only is kidney disease becoming more common among Hispanic groups, but the Hispanic population itself is growing disproportionately quickly. The 2000 U.S. Census reported that there are 35 million Hispanics/latinos in the United States. Hispanics already form the largest minority group in the United States, and Mexican Americans represent the largest subgroup, with a population of 21 million, followed by Puerto Ricans and Cubans. The U.S. Census has revealed that the Hispanic population grew from 10.3% in 1995 to 12.5% in 2000, making it among the fastest-growing of racial and ethnic groups. This rapid growth means that Hispanic patients with ESRD are likely to represent an ever-increasing proportion of the total population with ESRD. Despite the availability of effective interventions, healthcare services are failing to tackle the problem. Marked deficiencies are emerging in the provision of care to Hispanics at risk of kidney disease or its progression. Hispanic patients with kidney disease face an almost inevitable decline into chronic renal insufficiency and, ultimately, ESRD.
This review examines the issues contributing to racial disparities, including the risk factors that render Hispanics susceptible to kidney disease, and the complex interaction of cultural, social, and economic factors that appear to prevent this population from receiving adequate healthcare. Strategies to resolve the situation are proposed, including steps that policymakers and healthcare providers should take to improve outcomes for Hispanics and other minority groups at risk for kidney disease. Such measures will also ease healthcare costs. Recent forecasts predict that, unless aggressive preventive action is taken, expenditure in the Medicare kidney failure program will double over the next 10 years, exceeding US$28 billion by 2010.
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