Are Black Men More Susceptible to Kidney Disease?

An exploration into the high number of kidney-related incidents in the African American community

James Osborne

Two years ago, James Osborne, 39, walked into an emergency room with severe swelling in his ankles, calves and thighs. He started to put on weight several months prior to his hospital visit, but chalked it up to a lack of exercise and an unhealthy diet. “I’ve always been a big guy,” says the former college football player. “I knew I wasn’t hitting the gym or eating the best foods, so I thought I was just gaining weight.”

The doctors gave Osborne a urinalysis and discovered that he had a whopping 59,000 milligrams of protein in his urine (the amount of protein in a random sample of urine is normally less than eight milligrams). He was admitted into the hospital on the spot and stayed for two weeks. He was later diagnosed with Membranous Nephropathy, a rare kidney disorder that leads to changes and inflammation of the structures inside the kidney that help filter wastes and fluids.

“I was walking around with 100 pounds of fluid and I didn’t realize it,” says Osborne, a sewer foreman from Woodbridge, NJ. “The doctor told me that was the highest amount of protein he’d ever seen in his medical career. He couldn’t believe that I was able to function and that my kidneys weren’t completely shot. But the scariest thing of all is that I didn’t realize how sick I was until I started feeling better.”

According to, approximately 20 million Americans have some form of kidney disease. An even more sobering statistic: Black men between the ages of 20 to 29 are 10 times more likely to develop kidney failure due to high blood pressure than Caucasian men in the same age group. Furthermore, African American men between the ages of 30 to 39 are about 14 times more likely to develop kidney failure than their White counterparts. While hypertension and diabetes are the leading causes of kidney disease in the United States, when zeroing in on why the progression to kidney failure in the African American community is at a much higher rate, it may simply come down to two things: genetics and a lack of proper healthcare.

“There does seem to be an association between two particular genes in African Americans that are associated in developing kidney disease,” says Dr. Bryan Becker, former president of the National Kidney Foundation. “MYH9 and another gene called APLO1 seem to be more prominent in African Americans than individuals who aren’t African American, so there is probably something related to that. Second, we know that access to healthcare and reducing healthcare disparity likely has a beneficial impact on chronic kidney disease. If African American men develop hypertension and don’t have as much access to healthcare services, they miss out on treatment for their blood pressure and screenings for kidney disease at the right time to identify it and get the right treatment to prevent it. Reducing healthcare disparities, which we need to do for everybody, would benefit the African American community by increasing the number of people who are screened.”

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    • jeannie minnelli, Beth Israel Deaconess Medical Center

      Better ways to predict kidney disease risk for African Americans

      Martin Pollak, MD (Beth Israel Deaconess Medical Center) and his group looked to see if APOL1 gene variants confer risks for other types of kidney disease among 2,867 African Americans. Nondiabetic individuals with two APOL1 gene variants had a four-fold increased risk of developing chronic kidney disease over nondiabetics without the gene variants. (No increased risk occurred among diabetics.) “Our research shows that APOL1 variants explain the difference between the high rate of kidney disease in African Americans compared with European Americans,” said Dr. Pollak.

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  • Oshada

    I’m 31 and just found out I have PKD, bit woynrirg what the future will bring, but like you said there may well be a cure in the next 20 years or so, fingers crossed!

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    • Anna

      I’m praying for Jade and her petnars. Sometimes people progress beyond the initial diagnosis. Maybe she will walk again.Glad Christian is back home. What chapter are we on now, in the Kidney From Hell story? But hey, maybe it’s the Kidney from Heaven. Christian will probably have a much better understanding of some things than most people do, because of what he’s been through. You too. Not to sound preachy but, you know the Joseph story What was meant for evil, God meant for good. Hang in there. We’re all standing with ya.

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