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To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

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Kidney Week

Abstract: TH-PO741

The Disparities Map: It's Gone South!

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health


  • Ayub, Fatima, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
  • Easom, Andrea K., University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
  • Singh, Manisha, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

Over 300,000 Arkansans have chronic kidney disease (CKD) but are unaware they have it. Many live in rural, underserved areas. The Arkansas State CKD Advisory Council (ARCKDAC), was established in 2019 to promote CKD awareness and raise regional stakeholder engagement by identifying systemic barriers to equity. This initiative launched a model for early recognition and treatment of CKD, targeting the slowing of CKD progression and preparation for end-stage renal disease (ESRD), if needed. ARCKDAC identified gaps in CKD awareness and patient care through regional comparative data analysis and devised remedies that could be used by local stakeholders. This statewide collaborative approach to addressing CKD may be the nation's first.


ARCKDAC obtained regional data from ESRD Network 13 and compared incident data for 2016 and 2017 to better understand the differences. The analyses were distributed to stakeholders statewide to compare and contrast their outcomes and develop action plans for areas of concern in their region. ARCKDAC devised measures to support these plans and increase CKD awareness by developing a “Ten Point Checklist for Managing CKD” toolkit for primary care providers and a "Know Your Kidney Number (eGFR)" poster campaign to generate public awareness and identifying other available resources.


Approximately 1,200 Arkansans start ESRD therapies yearly. More minorities were in the two southern regions (54 to 65%) compared to 36% statewide. Medical coverage was not an issue, with 98% having insurance. Yet clinical outcomes were lowest in the south. Fewer patients (<3%) started on home dialysis in 2017 compared to 12% statewide and 19% in the central region where early CKD patient education is more accessible. Access to renal dietitians was low statewide (7%) but lower in the southern regions (1% and 3%). Pre-ESRD nephrology care was lowest in the southeast (45%) with 98% of patients starting hemodialysis and 93% using a catheter for access.


The ARCKDAC data reveals significant gaps, leading to poorer outcomes especially in rural areas. Having regional data analyzed and used by local stakeholders is the key to engagement and changes to address inequities. Public, provider and patient awareness and education campaigns may help mitigate this discordance. This approach could be a model that can be used to improve CKD outcomes nationally.


  • Private Foundation Support