Kidney Disease Disparities

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Compared to Whites, minority groups have a higher risk of developing ESRD:

  • Blacks have 4 times the risk
  • Native Americans have 2 times the risk
  • Hispanics have 2 times the risk
  • Asians have 1.6 times the risk

Source: Nicholas SB, Kalantar-Zadeh K, Norris KC. Racial disparities in kidney disease outcomes. Semin Nephrol. 2013;33(5):409-415.

In Michigan, African Americans make up only 14 percent of the general population, yet make up 43 percent of the dialysis population, and 37 percent of the kidney transplant waiting list. 

General Population (14%):
• United States Census Bureau, Quick Facts, 2020.
Dialysis Population (43%)
• United States Renal Data System, 2018 Annual Data Report: Epidemiology of Kidney Disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 20892. Accessed September 27, 2020
Kidney Transplant Waiting List (37%):
• Based on OPTN data as of September 16, 2020. This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

There are disparities between blacks and whites at every step along the transplant process.
Blacks are less likely to:

  • be identified as transplant candidates
  • be referred for a transplant evaluation
  • complete the evaluation
  • be placed on the waiting list
  • Black patients wait longer on the transplant list
  • Blacks are more likely to receive expanded criteria donor kidneys
  • Blacks are less likely to receive a kidney from a living donor
  • Black patients have poorer graft survival outcomes than white patients

Source: Norton et al., 2016 2 Norton JM, Moxey-Mims MM, Eggers PW, et al. Social Determinants of Racial Disparities in CKD. J Am Soc Nephrol. 2016;27(9):2576-2595.


Low socioeconomic status is strongly associated with kidney disease and ESRD. Those with a low socioeconomic status are more likely to have kidney disease and ESRD.

Source: Nicholas et al., 2015 3 Nicholas SB, Kalantar-Zadeh K, Norris KC. Socioeconomic disparities in chronic kidney disease. Adv Chronic Kidney Dis. 2015;22(1):6-15.