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Interventions to Address Structural Racism and Improve Outcomes in Kidney Disease Patients

May 2021 Council

Lead Division/Office


Point(s) of Contact

Paul L. Kimmel, M.D., M.A.C.P., F.R.C.P., F.A.S.N.; Jenna Norton, Ph.D., M.P.H.; Ivonne H. Schulman, M.D.

Executive Summary

Marginalized racial and ethnic groups who have been subject to structural racism experience disparate health outcomes relative to more privileged groups. Structural racism affects access to and quality of care, as well as access to social determinants of health, contributing to poor kidney health outcomes. Chronic stress and associated elevation in allostatic load induced by perceived discrimination and navigation of adverse social determinants of health are also associated with adverse health outcomes. Relatively few interventions have been tested to address the effects of racism in the lives of chronic kidney disease (CKD) and end stage renal disease (ESRD) patients. This initiative will invite applications that will develop and implement interventions targeting aspects of structural racism and/or perceived discrimination, to improve outcomes of patients with CKD or ESRD. Successful applicants will include a multidisciplinary and diverse principal investigator team and will involve community representatives in all aspects of the study. A Coordinating Center will provide statistical, methodological, and clinical trials support and will convene awardees annually to share progress and ideas. This initiative will provide a long overdue opportunity to address important and under-addressed contributors to racial and ethnic disparities in CKD and ESRD and will help develop an emerging research area in kidney disease.