The Effects of Race on Acute Kidney Injury

Abstract

Racial disparities in incidence and outcomes of acute kidney injury (AKI) are pervasive and are driven in part by social inequities and other factors. It is well-documented that Black patients face higher risk of AKI and seemingly have a survival advantage compared to White counterparts. Various explanations have been advanced and suggested to account for this, including differences in susceptibility to kidney injury, severity of illness, and socioeconomic factors. In this review, we try to understand and further explore the link between race and AKI using the incidence, diagnosis, and management of AKI to illustrate how race is directly related to AKI outcomes, with a focus on Black and White individuals with AKI. In particular, we explore the effect of race-adjusted estimated glomerular filtration rate (eGFR) equation on AKI prediction and discuss racial disparities in the management of AKI and how this might contribute to racial differences in AKI-related mortality among Blacks with AKI. We also identify some opportunities for future research and advocacy.

Regional variation of COVID-19 admissions, acute kidney injury and mortality in England - a national observational study using administrative data

“…The higher probability of AKI occurrence in London might be linked to the larger representation of males and individuals from ethnic minority backgrounds in its population. Both of these factors have been connected to an elevated risk of developing AKI [33,34]. The lower mortality rate observed in London can be attributed to the presence of a younger population and a diverse ethnic composition.…”

The Combined Treatment of Glutathione Sodium Salt and Ascorbic Acid for Preventing Contrast-Associated Acute Kidney Injury in ST-Elevation Myocardial Infarction Patients Undergoing Primary PCI: A Hypothesis to Be Validated

“…Major risk factors for AKI development are sepsis, hypovolemia, Chronic Kidney Disease (CKD) and diabetes mellitus [ 56 ]. The black race has an increased risk of AKI occurrence, which seem to be related to a direct interaction between genetic, as well as clinical and social class, factors [ 57 ]. Its pathophysiology consists of a complex multifactorial process [ 58 ].…”

Incidence, associated factors, and outcomes of acute kidney injury following placement of antibiotic bone cement spacers in two-stage exchange for periprosthetic joint infection: a comprehensive study

“…Meanwhile, the incidence of AKI varied across races and our study is the first to report the incidence of AKI in Asians in a large PJI cohort. Reports from other areas have shown that black patients tend to have a higher risk of AKI than white patients, and Asians also have a relatively low incidence of AKI ( Hassan and Balogun, 2022 ). However, black patients with AKI would have a lower in-hospital mortality rate ( Hassan et al., 2021 ).…”