ЗАБОЛЕВАНИЯ ПОЧЕК: БРЕМЯ БОЛЕЗНИ И ДОСТУПНОСТЬ МЕДИЦИНСКОЙ ПОМОЩИ

Расовые/этнические и социально-экономические различия при хронических заболеваниях почек известны на протяжении десятилетий, однако прогресс в их коррекции недостаточно высокий. В нескольких недавних исследованиях предлагается новое понимание коренных причин этих различий, отмечаются области, в которых необходимы будущие исследования, и определяются возможности для изменений в политике и клинической практике. Географические различия в распространенности ХБП существуют и варьируют в зависимости от расы. Прогрессирование ХБП является более быстрым для групп расовых/этнических меньшинств по сравнению с белыми и может быть в значительной степени, но не полностью, объяснено генетическими факторами. Существуют серьезные социально-экономические различия для пациентов, находящихся на диализе, и они варьируют в зависимости от расы, места проживания и лечебного учреждения. Различия в доступе к трансплантации почки от живого донора могут быть обусловлены, прежде всего, социально-экономическим статусом донора, а не факторами реципиента. Необходимо устранить различия в помощи пациентам с ХБП, в том числе в отношении направления ресурсов в районы и группы населения, где различия наиболее распространены, направить усилия к пониманию того, как наилучшим образом использовать появляющуюся информацию о вкладе генетических факторов в отмеченные диспропорции, и продолжить работу по выявлению модифицируемых факторов риска окружающей среды, а также социальных и поведенческих для целенаправленных вмешательств среди групп высокого риска.

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