Confronting Disparities in Kidney Disease

Can access to healthier food - and knowledge about nutrition - help control hypertension and prevent kidney disease from advancing?

February 26, 2018

Nephrologist Deidra Crews’ research is driven by many factors: her expertise in kidney disease, her calling to study issues affecting minority communities and her love of inquiry, to name a few. But this fact is at the center: African-Americans are at disproportionately higher risk for developing kidney failure than Caucasians.

Baltimore has one of the greatest disparities in the U.S., with African-Americans having up to four times greater risk compared with Caucasian residents of the city.

“Disparities in kidney disease have not received the attention that they should,” says Crews, who is associate vice chair for diversity and inclusion for the Department of Medicine. “There are not very many people working in this area.”

For her current National Institutes of Health-funded study, Crews is investigating whether access to healthier food - and knowledge about nutrition - can help control hypertension and prevent kidney disease from advancing.

Her work was recently recognized by Johns Hopkins with the President’s Frontier Award, which presents one faculty member each year with a five-year grant totaling $250,000. The award, created with a donation from university trustee Louis J. Forster and alumna Kathleen M. Pike, focuses on those who are poised to break new ground and be leaders in their fields.

“Deidra is a truly gifted and creative physician-scientist who has expanded the study of racial and socioeconomic disparities in kidney disease and, as important, tested interventions,” said Ron Daniels, president of The Johns Hopkins University. “Her work is already transforming the care of disadvantaged populations with this condition.”

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The award “will certainly go a long way to help support the work I am doing with the help of my collaborators,” Crews said. Her recent work focuses on how disparities among those with chronic kidney disease are affected by access to healthy foods and dietary patterns. Last year she was part of the Johns Hopkins Medicine Dean’s Symposium on Improving Minority Health and Achieving Health Equity, where she spoke about her work with a program that will deliver healthy food and potentially improve outcomes for African-Americans with hypertension and kidney disease in areas with limited food choices.

Crews said she could use the award to expand current studies, increase the size of her research team and travel to share the work nationally and around the world.

She is partnering with Klein’s ShopRite of Maryland, a Baltimore supermarket chain, to bring healthier food choices to the city’s “food deserts,” areas where healthy food options are scarce. Research shows that African-Americans often live in such food deserts.

Beginning this year and continuing for five years, her study will recruit low-income African-Americans with high blood pressure and early kidney disease to participate for one year. The first group will receive $30 worth of fruits, vegetables, nuts and beans per week, plus coaching on food choices. A second group will receive a gift card for independent shopping at ShopRite. ShopRite will deliver all food chosen in the study to a neighborhood community center for easy access by participants.

“My hope,” says Crews, “is to examine this modifiable risk factor for poor health and determine if this method of delivering healthy foods improves outcomes for African-Americans with hypertension and kidney disease.”

Learn more:

“5+ Nuts and Beans for Kidneys” - A study to see if eating meals high in fruits, vegetables, nuts, beans and lean meats, similar to the Dietary Approaches to Stop Hypertension (DASH) diet can protect the kidneys. fiveplus4kidneys.weebly.com/ (January 2018)

“African Americans with Uncontrolled Hypertension Often Lack Healthy Foods” ASN Kidney News kidneynews.org/kidney-news/special-sections/kidney-week-2015/african-americans-with-uncontrolled-hypertension-often-lack-healthy-foods (January 2016)

“Kidney Disease in Urban Poor Linked to Bad Eating Habits” Renal and Urology News renalandurologynews.com/kidney-disease-in-urban-poor-linked-to-bad-eating-habits/article/399041/ (February 2015)

For more information on research conducted within the Division of Nephrology, visit hopkinsmedicine.org/nephrology.