Kidney failure takes deadly toll on blacks in Chicago

[okarol]

TRIBUNE SPECIAL REPORT URBAN EPIDEMICS

Kidney failure takes deadly toll on blacks in Chicago
Experts focus on several overlapping factors including obesity and poverty

By Deborah L. Shelton

Tribune reporter

March 30, 2008

First in an occasional series about chronic diseases and their impact on urban communities.

Harvet Jones is 48, but he looks much older. Diabetes and high blood pressure have taken their toll.

When he walks, he leans his gaunt frame on a cane because his feet and legs swell and go numb, a complication of hypertension.

Jones' blood-sugar levels spike even though he has been injecting insulin for eight years to control it. A condition called diabetic retinopathy threatens to blind him.

Worst of all, his diabetes and hypertension steadily, relentlessly, mercilessly attacked his kidneys. He went on dialysis in February.

Jones has fallen victim to a quiet epidemic plaguing black Chicago. By the thousands, African-Americans are suffering kidney failure and facing the possibility of blindness, limb amputation, life on dialysis and premature death. Patients with end-stage kidney disease require dialysis or a transplant to survive.

In parts of the city's largely African-American South and West Sides, kidney failure rates are more than twice as high as the national average and three times higher than in the rest of the city, federal statistics show. Those differences are driven by staggeringly high rates of diabetes and hypertension—the top two causes of kidney failure—among Chicago's black residents.

"Hypertension and diabetes are killing us," said Donna Calvin, a Chicago nurse practitioner who specializes in prevention of kidney disease. "These diseases are devastating our community."

Recognizing that kidney failure has reached alarming levels, some individuals and groups are trying to turn those dismal statistics around. They are reaching out to African-Americans across the city with information about prevention, offering diabetes and hypertension screenings in churches, and intervening in various other ways.

Dr. Paul W. Crawford oversees a dialysis center near 95th Street and Western Avenue that is "bursting at the seams." To try to solve the problem at the source, the kidney specialist decided to open a prevention clinic in his large South Side practice.

"I'm treating the children of my patients for the same problems their parents had," Crawford said with exasperation. "And most of it is preventable."

• • •

Health experts think the high kidney failure rates in black neighborhoods are fueled by a combination of overlapping factors, including an obesity epidemic; high concentrations of poverty; and a lack of access to medical care, health insurance, affordable, safe places to exercise and supermarkets that sell inexpensive, healthy foods.

Those factors contribute to the high rates of hypertension and diabetes in the community. About 3,500 of every 100,000 black Chicagoans have been diagnosed with high blood pressure, compared with about 1,700 of every 100,000 whites. For diabetes, the rates are 1,700 per 100,000 African-Americans and 600 per 100,000 whites.

By sheer numbers, 180,000 African-Americans in Chicago have been diagnosed with either diabetes or hypertension, and about 62,000 black Chicagoans battle both, according to the Chicago Department of Public Health.

African-Americans are more prone than other groups to hypertension, though experts aren't sure why. It could be genetic; often hypertension runs in families. Diet could be a factor. Some researchers think another cause could be the stress of racism.

Experts say many African-Americans are unaware of how important it is to treat high blood pressure.

"We see so many people who haven't made the connection of how chronic hypertension affects their kidneys," said Courtney Nicholas, associate director of minority health programs for the American Kidney Fund.

The effects of these trends on black areas are clear.

In ZIP code 60620—which includes parts of Ashburn, Auburn Gresham, Beverly, Chatham, Greater Grand Crossing, Roseland and Washington Heights—390 people in every 100,000 suffer from end-stage kidney disease. In ZIP code 60624 on the West Side, it is 387 for every 100,000.

By comparison, the rate for Chicago is 124 cases per 100,000; for the nation, it is 150, according to the U.S. Renal Data System, a government database.

Though Latinos also are at higher risk of kidney failure, the problem is more acute among African-Americans. Nationally, 1 in 8 people who experience kidney failure are Latino, but 1 in 3 are black, Nicholas said. Chicago ZIP codes in the middle range for the disease "more often than not" have large Latino populations, she said.

In the city's black neighborhoods, dialysis centers are full. Whole families struggle medically, financially and emotionally. Significant numbers of people suffer serious, chronic illness during the prime of life, making them too sick to work and unable to move ahead economically.

Studies have reported that African-Americans develop kidney failure at an earlier age than whites, leaving them trapped in a cycle of illness and a poor quality of life during what should be their healthiest years. People die prematurely, leaving family members to grieve.

Diane Williams volunteers with the Chicago Association of Kidney Patients because she has experienced kidney failure up close. Her husband, Major League Baseball umpire Charlie Williams, faced a possible leg amputation and was undergoing dialysis when he died at 61 of complications of kidney failure in 2005. The group formed in 2003 on the Far South Side as a support group for African-Americans battling kidney disease.

"When you lose someone you love," Williams said, "there is always a hole in your soul."

Jones, diagnosed with diabetes 14 years ago, worries about what the future holds.

His brother Joseph McNeal, who has diabetes and is a year older, has been tethered to a dialysis machine for a year. Diabetic retinopathy robbed McNeal of his eyesight about 18 months ago. "It's scary to see what he's going through," said a downcast Jones, taking a break at his favorite neighborhood coffeehouse. "Especially when you have the same symptoms."

Weeks later, Jones was hospitalized for kidney failure and went on dialysis. Because of his worsening health problems, he moved from his Hyde Park home to live with another brother in Lombard.

Charles Baker, 57, was first diagnosed with high blood pressure when he was 16. He had a stroke in 1991, went on dialysis in 2001 and eventually got a kidney transplant.

His son, Jemil Floyd, who also has high blood pressure, started dialysis last April at age 17. Baker sobs at the thought of it. "I've been where he is," Baker said, his voice cracking.

• • •

A steady stream of people flowed last fall into the basement of Oakdale Covenant Church on South Vincennes Avenue to undergo a health screening organized by the American Kidney Fund.

Kidney disease had become too serious of a problem for the church to ignore, said Rev. D. Darrell Griffin, who said his own father died of complications of diabetes and kidney failure in 2005.

"This is something we hadn't addressed, and it's really alarming," Griffin said.

The screening was part of an intervention program by the fund, which aims to reduce high rates of kidney failure in minority communities by collaborating with public and private organizations. The group operates minority intervention programs in Chicago, Atlanta and Washington—cities with large African-American populations and high rates of kidney disease.

Samella Sutton, a pharmacist and member of the church's health ministry, led the congregants in an opening prayer: "Oh Lord, we pray for good health."

By noon, 61 members of the church, located in ZIP code 60620, had rolled up their sleeves to give blood samples, get their blood pressure levels taken and give urine specimens for testing.

After the screening, internist Dr. David Ellens led a question-and-answer session in the large basement.

"Let's prevent bad things from happening," he half-shouted into a microphone, listing the medical problems that could be staved off with good health practices. Stroke. Heart attack. Kidney disease. Kidney failure. Premature death.

Heads nodded.

"Thank you, Lord, for giving us this opportunity to talk to people about their health and well-being," Ellens said solemnly in a closing prayer. "We pray it is information they will use."

dshelton@tribune.com

http://www.chicagotribune.com/news/chi-dialysis_bd30mar30,0,2253536.story

[Chris]

I read this Saturday in the Chicago Tribune, but the story really didn't having anything new to say from their last story they did awhile back. However, atleast they are bring awareness to it and it was on the front page, not stuck somewhere no one looks.

[flip]

It isn't just Chicago. The number of black patients in my center are probably 3-4 times the overall population of the community. It's a serious problem usually related to diabetes and hypertension.

[Chris]

I think the paper was meant to bring attention to people in the Chicago area, but should have done a better job at explaining that it is just not Chicago that is affected or is it effected? But forgive me, Britney or someother dimwit star is more important to make the news to go into further detail into a more important topic.

[stauffenberg]

It is ironic that there should be so much emphasis on preventative medicine at the very same time that medicine is discovering that more and more medical conditions are genetically caused.  Everyone thinks that type 2 diabetes is simply the result of excess weight, but in fact, even in that form of the disease, genetics plays a major role, and not everyone who is overweight runs a greater risk of diabetes, while some people develop type 2 diabetes when they are still of normal weight.  Blacks are more than twice as likely to become diabetic in response to immunosuppressive drugs than Whites, and this has nothing to do with their weight.  It is simply the case that certain genes and genetic diseases cluster along racial and ethnic lines, which is why Jews have an abnormally high rate of Tay-Sachs Disease, people from the Mediterranean area have a higher rate of Thalissemia, and Blacks have a higher rate of hypertension, sickle cell anemia, and type 2 diabetes.  Nothing can be done about this until medical science over the next 50 to 100 years develops an effective technique for genetic engineering, or unless we undertake a eugenics program and urge people not to breed if they have certain diseases in their family.