Ethnic and geographic disparities in proteinuria and high blood pressure: a cross-sectional study from community kidney screenings in the Washington DC area.

BACKGROUND

chronic kidney disease (CKD) affects 14% of U.S adults, with 90% unaware of their condition. This study assessed ethnic and geographic disparities in proteinuria and hypertension through community outreach screening in underserved areas in the Washington, DC Metropolitan Statistical Area.

METHODS

We conducted a cross-sectional analysis of 1,597 adults through community screenings in underserved areas of the Washington DC Metropolitan Area. Screening assessments included semi-quantitative urine dipstick testing for proteinuria and automated blood pressure (BP) measurements. Participant forms collected demographic information, comorbidities, and healthcare engagement history. Two BP readings were obtained per participant, with the average recorded; measurements were repeated when initial readings were inconsistent. High-risk participants were defined as individuals with ≥ 1 of the following: proteinuria ≥ 30 mg/dL ( ≥ + 1), systolic BP ≥ 130 mmHg, diastolic BP ≥ 80 mmHg, or self-reported kidney disease. All participants received basic health counseling; high-risk participants received additional individualized guidance. High-risk participants (n = 245) were contacted once for follow-up, 2–4 weeks post-screening, to assess care-seeking behavior and CKD awareness.

RESULTS

African Americans were the predominant group and exhibited the highest prevalence of proteinuria and high blood pressure, followed by Hispanic/Latino individuals, with Caucasians having the lowest rates. Adjusted analysis showed African Americans and Hispanic/Latino participants had significantly higher odds of markedly elevated blood pressure (> 160/95 mmHg) compared to Caucasians. Crude analysis revealed higher proteinuria rates among residents of DC Wards 1–4 and 7–8, and Maryland, compared to Virginia. Among 245 high-risk participants contacted, 92 (37.6%) responded; 48 (52.2%) had visited a physician, and 31 (33.7%) planned to seek care. Post-screening surveys indicated that 60% of respondents reported increased awareness of CKD.

CONCLUSION

This community-based screening program identified significant racial/ethnic and geographic disparities in CKD risk factors, particularly among African American participants and residents of specific DC wards. Screening events can improve early identification of CKD risk markers, increase awareness, and encourage healthcare engagement in high-risk populations.