Chronic Renal Disease and African-Americans
U-M participates in nationwide study of all aspects of disease, including
disparities
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Akinlolu Ojo
Photo: Martin Vloet |
Akinlolu Ojo, M.D., Ph.D., an associate professor of internal medicine at
Michigan, will spend five years monitoring 500 Detroit-area patients as part
of a multi-center clinical trial documenting all aspects of chronic renal disease
— including racial disparities. The Chronic Renal Insufficiency Cohort Study
will examine genetic, demographic, environmental, behavioral, nutritional and
quality-of-life factors affecting patients with kidney disease. It also will
explore their access to and utilization of health resources. The study, which
will follow 3,000 patients nationwide, is funded by the National Institutes
of Health and involves researchers at Case Western Reserve University, Johns
Hopkins, Tulane, the University of Illinois, the University of Pennsylvania
and Kaiser Permanente, in addition to the U-M.
More than 10 million Americans have chronic renal disease — and it is four
to five times more likely to afflict African-Americans than other groups. Ojo
and his colleagues at U-M have formed a unique alliance with investigators
in the Detroit area to ensure that 150-250 African-Americans are recruited
for the project, which began in September 2001 and is scheduled for completion
in 2008. Researchers will monitor patients' renal function and cardiovascular
health, and patients whose condition progresses to end-stage renal disease
will be tracked as they undergo dialysis and kidney transplants. "One of the
most difficult and unfortunate things about loss of kidney function is that
patients don't notice anything until the kidney function gets quite low, almost
to the point of no return," Ojo says.
Disparities in healthcare have long been of interest to Ojo. Early in his
career, he and colleagues at Texas A&M University conducted a study that
found socio-economic factors — income, education, employment, and insurance
status — created barriers to kidney transplantation. In another project, he
investigated why African-American men have lower survival rates following kidney
transplants than non-Hispanic whites — and found evidence that large out-of-pocket
costs made it difficult for some patients to maintain a steady supply of crucial
transplant medications. "This was an attempt to determine whether non-compliant
behavior was a function of financial hardship," Ojo says. "Patients who are
left with a substantial amount of out-of-pocket payments for transplant medications
are more likely to lose their transplants prematurely."
Today, in collaboration with the Gift of Life Foundation of Michigan and the
NIH, Ojo is evaluating means for increasing organ donation among racial minorities.
He also is a co-principal investigator for the African-American Study of Kidney
and Hypertension, the first major study of kidney disease among blacks.
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