Chronic kidney disease globally resulted in 735,000 deaths in 2010 up from 400,000 deaths in 1990.[36]
In Canada 1.9 to 2.3 million people have chronic kidney disease.[24] In the US, the Centers for Disease Control and Prevention found that CKD affected an estimated 16.8% of adults aged 20 years and older, during 1999 to 2004.[37] UK estimates suggest that 8.8% of the population of Great Britain and Northern Ireland have symptomatic CKD.[38]
Chronic kidney disease (CKD) is a major concern in African Americans, mostly due to increased prevalence of hypertension. As an example, 37% of end-stage renal disease cases in African Americans can be attributed to high blood pressure, compared with 19% among caucasians.[39] Treatment efficacy also differs between racial groups. Administration of anti-hypertensive drugs generally halts disease progression in white populations, but has little effect in slowing renal disease among blacks, and additional treatment such as bicarbonate therapy is often required.[39] While lower socioeconomic status contributes to prevalence of CKD, there are still significant differences in CKD prevalence between African Americans and whites when controlling for environmental factors.[39] Studies have shown that there is a true association between history of chronic renal failure in first or second-degree relatives, and risk of disease.[40] In addition, African Americans may have higher serum levels of human leukocyte antigens (HLA).[40] High HLA concentrations can contribute to increased systemic inflammation, which indirectly may lead to heightened susceptibility for developing kidney disease. Lack of nocturnal reduction in blood pressure among groups of African Americans is also offered as an explanation,[40] which lends further credence to a genetic etiology of CKD racial disparities.
