Race differences in access to health care and disparities in incident chronic kidney disease in the US.

BACKGROUND: The contribution of race differences in access to health care to disparities in chronic kidney disease (CKD) incidence in the United States is unknown.

METHODS: We examined race differences in usual source of health care, health insurance and CKD incidence among 3883 Whites and 1607 Blacks with hypertension or diabetes enrolled in the Atherosclerosis Risk in Communities Study. In multivariable analyses, we explored the incremental contribution of access to health care in explaining Blacks' excess CKD incidence above and beyond other socioeconomic, lifestyle and clinical factors.

RESULTS: Compared with Whites, Blacks had poorer access to health care (3 vs 0.3% with no usual source of health care or health insurance, P