Although kidney failure and its leading causes disproportionately affect African Americans, they are largely unaware of their high risk and of preventive measures, according to the first NIH study to assess the group's knowledge and awareness about kidney disease.

While 90 per cent of African Americans surveyed by the National Kidney Disease Education Program (NKDEP) had heard about kidney disease, only 15 per cent felt their personal risk for developing the disease was higher than average and fewer knew specifically how to prevent it. This gap in awareness raises serious concern, especially because 44 per cent of them had at least one major risk factor for kidney disease -- diabetes, high blood pressure or a blood relative with the disease.

In addition, only 17 per cent named kidney disease as a consequence of diabetes and only 8 per cent named it as a consequence of hypertension. These two diseases are the leading causes of kidney failure in the United States and account for 70 per cent of kidney failure among African Americans.

"We clearly need to work closely within our community to provide the facts about kidney disease," said Janice Lea, M.D., spokesperson for Atlanta's NKDEP coalition. "One step we are taking is asking dialysis patients to encourage relatives and friends who are at high risk to take the disease seriously and be tested while they can still do something about it."

The poll also found that 52 per cent of people knew at least one major cause of kidney disease, but 48 per cent were unable to name any cause and others named incorrect causes such as drinking sodas. When asked about symptoms of early kidney disease, 13 per cent correctly said that there are none, while 64 per cent expected early symptoms to include difficulty urinating, general pain and frequent urination.

"Kidney disease is a silent killer. People find themselves in the emergency room, on dialysis, before they even know they have a problem," said Dr. Lea. "That's why it is so important to control diabetes and high blood pressure and have your blood and urine regularly tested for kidney disease once you know you are at risk."

While anyone can develop kidney disease, African Americans are hit especially hard. An estimated 36 in 100,000 African Americans versus 11 in 100,000 Whites were treated for kidney failure in 2001. African Americans have four times the risk of kidney failure and those with diabetes have up to six times the risk compared to White counterparts. But the biggest disparity is among African American men ages 25 to 44, who are 20 times more likely to develop kidney failure compared to corresponding Whites.

Epidemic numbers of people -- roughly 20 million - have kidney disease and another 400,000 or more are already on dialysis or have a kidney transplant because their kidneys failed. The cost to taxpayers, insurers, and patients was an estimated $22.8 billion in 2001 alone.