Reducing Health Disparities in American Indians With Chronic Kidney Disease
Summary
American Indians and Alaska Natives comprise a diverse population with an increased burden of chronic kidney disease (CKD), largely owing to diabetes. Although transportation to rural dialysis units impairs access, quality of dialysis care appears similar to the US population. Similar to other racial and ethnic minorities, American Indians and Alaska Natives are less likely to receive kidney transplants. The causes of these disparities are as diverse as the population. The application of the chronic care model to CKD by the Indian Health Service is associated with a decrease in incidence of end-stage renal disease among diabetic patients and may be a useful model for reducing disparities in other populations at risk for CKD.
⁎National Kidney Disease Education Program, National Institute of Diabetes and Digestive and Kidney Diseases, Clinical Consultant for Nephrology, Indian Health Service, Bethesda, MD
†Department of Medicine, Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA
‡Harvard Medical School, Department of Health Care Policy, Boston, MA
Address reprint requests to Andrew S. Narva, MD, Director, National Kidney Disease Education Program, Division of Kidney, Urologic and Hematologic Diseases, National Institute for Diabetes and Digestive Kidney Diseases, National Institutes of Health, Two Democracy Plaza, Room 644, 6707 Democracy Blvd, MSC 5458, Bethesda, MD 20892-5458
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