African–Americans and Kidney Disease: New Insights into an Old Problem

Chronic kidney disease and end-stage renal disease are a growing epidemic, both in the United States and worldwide. African–Americans are disproportionately afflicted with kidney disease. The reasons for this disparity are multiple, but ultimately unclear. Not only are diabetes mellitus and hypertension more prevalent in African–Americans, but also end-organ damage from these processes appears also to be accelerated. Also, certain primary and secondary glomerular diseases are more prevalent and more severe in African–Americans than in Caucasians. Despite controlling for these factors and socioeconomic status, the increased prevalence of kidney disease in African–Americans is still not entirely explained. Recently, two studies identified certain alleles within the MYH9 gene locus that are more frequently expressed in African–Americans with focal segmental glomerulosclerosis and non-diabetic renal disease. These studies emphasize the important role that genetic factors may play in explaining racial discrepancies in kidney disease, and represent exciting areas for new research.